ArticleInterventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences2019
Endovascular retrograde approach may be a better option for acute tandem occlusions stroke.
Article in Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Hyperacute stenting and angioplasty for acute extracranial non-tandem internal carotid artery strokes within the first 48 h: A 20-year experience and a systematic review and meta-analysis.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Pooled it
- Antegrade or Retrograde Approach for the Management of Tandem Occlusions in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.Frontiers in neurology · 2021Pooled it
- The T-Top Technique for Tandem Lesions: A Single-Center Retrospective Study.Journal of clinical medicine · 2025Article
- Current trends in antiplatelet strategies for emergent carotid stenting in acute tandem occlusions: a web-based, nationwide survey in the Italian neurovascular community.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Diagnosis and management ofEuropean journal of radiology open · 2023Article
- Evidence-Based Updates to Thrombectomy: Targets, New Techniques, and Devices.Frontiers in neurology · 2021Review
- Experimental Analysis of Intra-luminal Pressure by Contrast Injection during Mechanical Thrombectomy: Simulation of Rupture Risk of Hidden Cerebral Aneurysm in Tandem Occlusion with Blind Alley.Neurologia medico-chirurgica · 2020Article
- Treatment Strategies for Tandem Occlusions in Acute Ischemic Stroke.Seminars in interventional radiology · 2020Review
- Carotid Revascularization: Current Practice and Future Directions.Seminars in interventional radiology · 2020Review
- Intravenous Thrombolysis Benefits Mild Stroke Patients With Large-Artery Atherosclerosis but No Tandem Steno-Occlusion.Frontiers in neurology · 2020Article
- Treatment outcomes of antegrade versus retrograde approaches in tandem occlusion: a single-center retrospective study from Vietnam.Frontiers in neurologyArticle
- Endovascular Treatment for Acute Tandem Occlusion Stroke: Results from Case Series of 17 Patients.Annals of Indian Academy of NeurologyArticle
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12 authors at 5 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveThe endovascular treatment strategy for acute tandem occlusion stroke is challenging, and controversy exists regarding which lesion should be treated first. This study addresses the uncertainty regarding the priority choice for thrombectomy in acute anterior circulation tandem occlusion stroke.
methodsWe analysed the clinical and angiographic data of tandem stroke patients who underwent interventional therapy from the endovAsCular Treatment of acUte Anterior circuLation ischaemic stroke (ACTUAL) registry. Recanalisation was assessed according to the modified thrombolysis in cerebral infarction score. Clinical outcome was evaluated at 90 days using the modified Rankin scale score.
resultsSixty tandem occlusion stroke patients were enrolled. Thirty-one (51.7%) patients received anterograde therapy, while 29 (48.3%) patients underwent the retrograde approach. Successful recanalisation (modified thrombolysis in cerebral infarction score 2b-3) occurred in 78.3% (47/60) of patients, and 50.0% (30/60) of patients achieved a modified Rankin scale score of 0-2 at 90 days. Patients undergoing the retrograde approach spent less time in distal occlusion recanalisation (125 (86-167) vs. 95 (74-122) minutes; P = 0.04) and achieved better functional outcomes at 90 days (69.0% (20/29) vs. 32.3% (10/31); P = 0.004) than patients who received anterograde therapy. The retrograde approach was associated with favourable clinical outcomes (odds ratio 0.21; 95% confidence interval 0.07-0.64; P = 0.006).
conclusionFor acute tandem occlusion stroke, favourable outcomes were better in patients undergoing retrograde therapy than in patients who received the anterograde approach. Future randomised trials are warranted to determine the optimal treatment.
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