Diagnosis and management of
Acute Ischemic Stroke
Endovascular Thrombectomy
Stenting
Tandem Occlusion
Tandem lesion
Journal
European journal of radiology open
ISSN: 2352-0477
Titre abrégé: Eur J Radiol Open
Pays: England
ID NLM: 101650225
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
05
06
2023
revised:
31
07
2023
accepted:
07
08
2023
medline:
23
8
2023
pubmed:
23
8
2023
entrez:
23
8
2023
Statut:
epublish
Résumé
Approximately 20-30% of patients with acute ischemic stroke, caused by large intracranial vessel occlusion, have a tandem lesion, defined as simultaneous presence of high-grade stenosis or occlusion of the cervical internal carotid artery and thromboembolic occlusion of the intracranial terminal internal carotid artery or its branches, usually the middle cerebral artery. Patients with tandem lesions have usually worse outcomes than patients with single intracranial occlusions, and intravenous thrombolysis is less effective in these patients. Although endovascular thrombectomy is currently a cornerstone therapy in the management of acute ischemic stroke due to large vessel occlusion, the optimal management of extracranial carotid lesions in tandem occlusion remains controversial. Acute placement of a stent in the cervical carotid artery lesion is the most used therapeutic strategy compared with stented balloon angioplasty and thrombectomy alone without carotid artery revascularization; however, treatment strategies in these patients are often more complex than with single occlusion, so treatment decisions can change based on clinical and technical considerations. The aim of this review is to analyze the results of different studies and trials, investigating the periprocedural neurointerventional management of patients with tandem lesions and the safety, efficacy of the different technical strategies available as well as their impact on the clinical outcome in these patients, to strengthen current recommendations and thus optimize patient care.
Identifiants
pubmed: 37609048
doi: 10.1016/j.ejro.2023.100513
pii: S2352-0477(23)00039-4
pmc: PMC10440394
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100513Informations de copyright
© 2023 The Authors.
Déclaration de conflit d'intérêts
There are no conflicts of interest in this review.
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