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Carotid artery stenting during endovascular thrombectomy for acute ischemic stroke with tandem occlusion: the Italian Registry of Endovascular Treatment in Acute Stroke.
- Source :
-
Acta neurologica Belgica [Acta Neurol Belg] 2023 Apr; Vol. 123 (2), pp. 475-485. Date of Electronic Publication: 2022 Sep 02. - Publication Year :
- 2023
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Abstract
- Purpose: The management of tandem extracranial internal carotid artery and intracranial large vessel occlusion during endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) has been under-investigated. We sought to investigate outcomes of AIS patients with tandem occlusion (TO) treated with carotid artery stenting (CAS) compared to those not treated with CAS (no-CAS) during EVT.<br />Methods: We performed a cohort study using data from AIS patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke. Outcomes were 3 months' mortality, functional outcome, complete and successful recanalization, any intracranial hemorrhage, parenchymal hematoma and symptomatic intracerebral hemorrhage.<br />Results: Among 466 AIS patients with TO, CAS patients were 122 and no-CAS patients were 226 (118 excluded). After adjustment for unbalanced variables, CAS was associated with a lower rate of 3 months' mortality (OR 0.407, 95% CI 0.171-0.969, p = 0.042). After adjustment for pre-defined variables, CAS was associated with a lower rate of 3 months' mortality (aOR 0.430, 95% CI 0.187-0.989, p = 0.047) and a higher rate of complete recanalization (aOR 1.986, 95% CI 1.121-3.518, p = 0.019), successful recanalization (aOR 2.433, 95% CI 1.263-4.686, p = 0.008) and parenchymal hematoma (aOR 2.876, 95% CI 1.173-7.050, p = 0.021). CAS was associated with lower 3 months mortality (OR 0.373, 95% CI 0.141-0.982, p = 0.046) and higher rates of successful recanalization (OR 2.082, 95% CI 1.099-3.942, p = 0.024) after adjustment for variables associated with 3 months' mortality and successful recanalization, respectively.<br />Conclusions: Among AIS patients with TO, CAS during EVT was associated with a higher rate of successful reperfusion and a lower rate of 3 months' mortality.<br /> (© 2022. The Author(s) under exclusive licence to Belgian Neurological Society.)
- Subjects :
- Humans
Cohort Studies
Treatment Outcome
Stents
Thrombectomy
Registries
Hematoma etiology
Carotid Arteries
Retrospective Studies
Carotid Artery, Internal
Ischemic Stroke complications
Carotid Stenosis complications
Endovascular Procedures
Stroke
Brain Ischemia surgery
Brain Ischemia complications
Subjects
Details
- Language :
- English
- ISSN :
- 2240-2993
- Volume :
- 123
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Acta neurologica Belgica
- Publication Type :
- Academic Journal
- Accession number :
- 36056270
- Full Text :
- https://doi.org/10.1007/s13760-022-02067-z