Endovascular treatment of patients with acute ischemic stroke and tandem occlusion due to internal carotid artery dissection: A multicenter experience.
Humans
Male
Adult
Middle Aged
Aged
Aged, 80 and over
Female
Carotid Artery, Internal, Dissection
/ complications
Ischemic Stroke
/ complications
Carotid Stenosis
/ surgery
Retrospective Studies
Treatment Outcome
Endovascular Procedures
/ methods
Stents
/ adverse effects
Stroke
/ therapy
Carotid Artery, Internal
/ surgery
Thrombectomy
/ methods
Endovascular
Internal carotid artery dissection
Interventional
Ischemic stroke
Stroke
Tandem occlusion
Thrombectomy
Journal
The neuroradiology journal
ISSN: 2385-1996
Titre abrégé: Neuroradiol J
Pays: United States
ID NLM: 101295103
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
pmc-release:
01
02
2024
pubmed:
15
6
2022
medline:
26
1
2023
entrez:
14
6
2022
Statut:
ppublish
Résumé
The optimal management of patients with acute ischemic stroke (AIS) due to tandem occlusion (TO) and underlying carotid dissection (CD) remains unclear. We present our multicenter-experience of endovascular treatment (EVT) approach used and outcomes for AIS patients with CD-related TO (CD-TO). Consecutive AIS patients underwent EVT for CD-TO at five Italian Neuro-interventional Tertiary Stroke Centers were retrospectively identified. TO from atherosclerosis and other causes of, were excluded from the final analysis. Primary outcome was successful (mTICI 2b-3) and complete reperfusion (mTICI 3); secondary outcome was patients' 3-months functional independence (mRS≤2). Among 214 AIS patients with TO, 45 presented CD-TO. Median age was 54 years (range 29-86), 82.2% were male. Age <65 years ( AIS patients with CD-TO were mostly treated with the retrograde approach with lower number of attempts per-procedure but it offered similar recanalization rates compared with the antegrade approach. Emergent carotid artery stenting (CAS) proved to be safe for CD management but it does not influence 3-months patients' clinical outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
The optimal management of patients with acute ischemic stroke (AIS) due to tandem occlusion (TO) and underlying carotid dissection (CD) remains unclear.
OBJECTIVE
OBJECTIVE
We present our multicenter-experience of endovascular treatment (EVT) approach used and outcomes for AIS patients with CD-related TO (CD-TO).
METHODS
METHODS
Consecutive AIS patients underwent EVT for CD-TO at five Italian Neuro-interventional Tertiary Stroke Centers were retrospectively identified. TO from atherosclerosis and other causes of, were excluded from the final analysis. Primary outcome was successful (mTICI 2b-3) and complete reperfusion (mTICI 3); secondary outcome was patients' 3-months functional independence (mRS≤2).
RESULTS
RESULTS
Among 214 AIS patients with TO, 45 presented CD-TO. Median age was 54 years (range 29-86), 82.2% were male. Age <65 years (
CONCLUSION
CONCLUSIONS
AIS patients with CD-TO were mostly treated with the retrograde approach with lower number of attempts per-procedure but it offered similar recanalization rates compared with the antegrade approach. Emergent carotid artery stenting (CAS) proved to be safe for CD management but it does not influence 3-months patients' clinical outcomes.
Identifiants
pubmed: 35699167
doi: 10.1177/19714009221108673
pmc: PMC9893158
doi:
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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