Endovascular Therapy Strategy for Acute Embolic Tandem Occlusion: The Pass-Thrombectomy-Protective Thrombectomy (Double PT) Technique

World Neurosurgery
Wen-Huo ChenXiao-Hui Lin

Abstract

Embolic occlusions of the common carotid artery (CCA)/internal carotid artery (ICA) and intracranial artery occlusions in acute ischemic stroke are associated with high morbidity and can benefit from endovascular therapy. However, the optimal endovascular strategy for these conditions is unclear. This study aimed to evaluate the feasibility of the pass-thrombectomy-protective thrombectomy (double PT) technique and the clinical outcome of treated patients. We collected data on embolic occlusion of the CCA/ICA and intracranial artery occlusion in our prospective stroke registry database between January 2015 and February 2017. Clinical and angiographic data were retrospectively analyzed. Clinical outcome was evaluated at 3 months (modified Rankin scale [mRS] score), and an mRS score of 2 or lower was defined as a good clinical outcome. A total of 7 patients with tandem occlusion were included, with a mean age of 66 years. The median admission National Institutes of Health Stroke Scale score was 20, and 6 of 7 patients (85.7%) underwent successful recanalization. The median reperfusion time of the affected intracranial artery was 61 minutes. The rate of good clinical outcome was 42.9% (3/7), the mortality rate was 14.3% (1/7), and ...Continue Reading

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