Carotid angioplasty-assisted mechanical thrombectomy without urgent stenting may be a better option in acute tandem occlusions

Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences
Cetin Kursad AkpinarEmrah Aytac

Abstract

Background The aim of the study was to assess the efficacy of balloon angioplasty-assisted mechanical thrombectomy without urgent stenting in the carotid artery as another approach for endovascular treatment of tandem occlusions. Methods Fifteen consecutive cases of tandem occlusions treated with the endovascular approach between January 2014 and May 2016 were reviewed. The study cohort included patients with an etiology of large vessel atherosclerosis. Extracranial carotid stenting was performed in another session if post-thrombectomy mRS modified Rankin Score (mRS) was 0-2. Good clinical outcome was determined by follow-up at 7-10, 30 and 90 days according to the mRS. Results Most patients (80%) were male. Eight (53.4%) patients received intravenous thrombolysis before angiography. Proximal revascularization was successful in 100% of cases with balloon angioplasty internal carotid artery (ICA) origin. Successful recanalization (modified thrombolysis in cerebral infarction (mTICI) 2b-3) (mTICI 2 b-3) occurred in 12 cases (80%) and good clinical outcomes were achieved in 10 patients (66.7%). Cervical ICA stent placement was performed in 10 patients with good clinical outcomes. No symptomatic intracranial hemorrhage occurred aft...Continue Reading

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Citations

Dec 26, 2018·Stroke; a Journal of Cerebral Circulation·Ashutosh P JadhavTudor G Jovin
Nov 8, 2019·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Alexandra R PaulAlan S Boulos
Jul 27, 2017·Current Neurology and Neuroscience Reports·Mahesh V JayaramanMayank Goyal
May 11, 2018·Clinical Neuroradiology·Pervinder BhogalLeonard Yeo
Aug 18, 2021·Journal of the Neurological Sciences·Aayushi GargSantiago Ortega-Gutierrez

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Carotid Artery Diseases

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