SynthesisJournal of the American Heart Association2022
Acute Carotid Artery Stenting Versus Balloon Angioplasty for Tandem Occlusions: A Systematic Review and Meta-Analysis.
Synthesis in Journal of the American Heart Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06397638 (Rescue Carotid Stenting in Tandem Occlusions), which is not on this map. Cited by 28 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Rescue Carotid Stenting in Tandem Occlusions: 4-year Experience From a Comprehensive Stroke Centre
Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 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
- Trial
- Simultaneous treatment of symptomatic cervical and tandem intracranial carotid lesions using transcarotid artery revascularization.Journal of vascular surgery cases and innovative techniques · 2026Article
- Cervical Internal Carotid Artery Reocclusion After Endovascular Thrombectomy in Tandem Occlusion: A Meta-Analysis.Stroke (Hoboken, N.J.) · 2026Article
- Endovascular management of tandem occlusions: current evidence and future directions.Journal of neurointerventional surgery · 2026Review
- Management of tandem occlusions in acute ischaemic stroke.Therapeutic advances in neurological disorders · 2026Review
- Microcatheter delivery of embolic protection devices for acute atherosclerotic tandem occlusion: patient series.Journal of neurosurgery. Case lessons · 2025Article
- PICASSO (Proximal Internal Carotid Artery Acute Stroke Secondary to Tandem Lesion or Local Occlusion) Thrombectomy Randomized Trial: Study Protocol and Rationale.Stroke (Hoboken, N.J.) · 2025Article
- Rescue carotid stenting in tandem occlusions: 5 years' experience from a comprehensive stroke center.Journal of Taibah University Medical Sciences · 2025Article
- The Dual-layer CGuard Stent Is Safe and Effective in Emergent Carotid Artery Stenting and in Tandem Occlusions: a Multi-centric Study.Clinical neuroradiology · 2025Article
- Stenting Versus Non-stenting Strategy in Endovascular Treatment of Acute Anterior Ischemic Stroke Patients with Tandem Occlusion.Annals of Indian Academy of Neurology · 2025Article
- Effects of Emergent Carotid Stenting Performed before or after Mechanical Thrombectomy in the Endovascular Management of Patients with Tandem Lesions: A Multicenter Retrospective Matched Analysis.AJNR. American journal of neuroradiology · 2025Article
- Repeated Re-occlusion during the Procedure of Mechanical Thrombectomy with Retrograde Approach for Tandem Occlusion Including T Occlusion: A Case Report.Journal of neuroendovascular therapy · 2025Article
- Analysis of risk factors for poor prognosis after endovascular treatment of tandem lesions in acute ischemic stroke.Frontiers in neurology · 2025Article
- Safety, efficacy and timing of antithrombotic therapy in emergency stenting of acute stroke patients with tandem lesions, German multicenter data-analysis.Frontiers in neurology · 2025Article
- MicroNET-covered stent (CGuard) routine use in acute carotid-related stroke - SAFEGUARD-STROKE Study: response to the Buffalo Group commentary.Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2024Article
- A multi-center study of the MicroNET-covered stent in consecutive patients with acute carotid-related stroke: SAFEGUARD-STROKE.Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2024Article
- Endovascular treatment of acute ischemic stroke patients with tandem lesions: antegrade versus retrograde approach.Journal of neurosurgery · 2024Article
- Association of perioperative P2YFrontiers in neurology · 2024Article
- Immediate Carotid Artery Stenting or Deferred Treatment in Patients With Tandem Carotid Lesions Treated Endovascularly for Acute Ischaemic Stroke.EJVES vascular forum · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background Despite thrombectomy having become the standard of care for large-vessel occlusion strokes, acute endovascular management in tandem occlusions, especially of the cervical internal carotid artery lesion, remains uncertain. We aimed to compare efficacy and safety of acute carotid artery stenting to balloon angioplasty alone on treating the cervical lesion in tandem occlusions. Similarly, we aimed to explore those outcomes' associations with technique approaches and use of thrombolysis. Methods and Results We performed a systematic review and meta-analysis to compare functional outcomes (modified Rankin Scale), reperfusion, and symptomatic intracranial hemorrhage and 3-month mortality. We explored the association of first approach (anterograde/retrograde) and use of thrombolysis with those outcomes as well. Two independent reviewers performed the screening, data extraction, and quality assessment. A random-effects model was used for analysis. Thirty-four studies were included in our systematic review and 9 in the meta-analysis. Acute carotid artery stenting was associated with higher odds of modified Rankin Scale score ≤2 (odds ratio [OR], 1.95 [95% CI, 1.24-3.05]) and successful reperfusion (OR, 1.89 [95% CI, 1.26-2.83]), with no differences in mortality or symptomatic intracranial hemorrhage rates. Moreover, a retrograde approach was significantly associated with modified Rankin Scale score ≤2 (OR, 1.72 [95% CI, 1.05-2.83]), and no differences were found on thrombolysis status. Conclusions Carotid artery stenting and a retrograde approach had higher odds of successful reperfusion and good functional outcomes at 3 months than balloon angioplasty and an anterograde approach, respectively, in patients with tandem occlusions. A randomized controlled trial comparing these techniques with structured antithrombotic regimens and safety outcomes will offer definitive guidance in the optimal management of this complex disease.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.