ArticleEuropean journal of radiology open2023
Diagnosis and management of
Article in European journal of radiology open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Intravenous thrombolysis with tenecteplase versus alteplase in acute ischemic stroke tandem occlusions: a systematic review and meta-analysis of current available literature.Journal of thrombosis and thrombolysis · 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
- Accuracy of Distal Internal Carotid Artery Contrast Ratio to Infer Proximal Carotid Disease in the Mobile Stroke Unit.Stroke (Hoboken, N.J.) · 2026Article
- Endovascular management of tandem occlusions: current evidence and future directions.Journal of neurointerventional surgery · 2026Review
- Two Birds, One Stone: Synchronous Recanalization of the Middle Cerebral Artery and Anterior Cerebral Artery in Acute Ischemic Stroke.Annals of Indian Academy of Neurology · 2026Article
- Endovascular Acute Stroke Intervention-Tandem Occlusion (EASI-TOC) study: protocol and rationale.European stroke journal · 2026Article
- Management of tandem occlusions in acute ischaemic stroke.Therapeutic advances in neurological disorders · 2026Review
- Flow-Diverting Stents During Mechanical Thrombectomy for Carotid Artery Dissection-Related Stroke: Analysis from a Multicentre Cohort.Brain sciences · 2025Article
- The T-Top Technique for Tandem Lesions: A Single-Center Retrospective Study.Journal of clinical medicine · 2025Article
- Can Serum GFAP and UCH-L1 Replace CT in Assessing Acute Ischemic Stroke Severity?Life (Basel, Switzerland) · 2025Article
- Internal carotid artery dissection leading to occlusion in a patient with nonelongated styloid process: illustrative case.Journal of neurosurgery. Case lessons · 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
- Thrombectomy With Bridging Thrombolytic May Benefit Asian Patients More Than Non-Asian Patients: Insights From DIRECT-SAFE Sub-Analysis.Journal of stroke · 2025Article
- The Railroad Technique: A Mechanical Thrombectomy Approach Using Serial Deployment of Two Stent Retrievers for Tandem ICA-M1 Embolic Occlusion.Journal of neuroendovascular therapy · 2025Article
- 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
- The Importance of Increased Serum GFAP and UCH-L1 Levels in Distinguishing Large Vessel from Small Vessel Occlusion in Acute Ischemic Stroke.Biomedicines · 2024Article
- Treatment outcomes of antegrade versus retrograde approaches in tandem occlusion: a single-center retrospective study from Vietnam.Frontiers in neurologyArticle
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Approximately 20-30% of patients with acute ischemic stroke, caused by large intracranial vessel occlusion, have a tandem lesion, defined as simultaneous presence of high-grade stenosis or occlusion of the cervical internal carotid artery and thromboembolic occlusion of the intracranial terminal internal carotid artery or its branches, usually the middle cerebral artery. Patients with tandem lesions have usually worse outcomes than patients with single intracranial occlusions, and intravenous thrombolysis is less effective in these patients. Although endovascular thrombectomy is currently a cornerstone therapy in the management of acute ischemic stroke due to large vessel occlusion, the optimal management of extracranial carotid lesions in tandem occlusion remains controversial. Acute placement of a stent in the cervical carotid artery lesion is the most used therapeutic strategy compared with stented balloon angioplasty and thrombectomy alone without carotid artery revascularization; however, treatment strategies in these patients are often more complex than with single occlusion, so treatment decisions can change based on clinical and technical considerations. The aim of this review is to analyze the results of different studies and trials, investigating the periprocedural neurointerventional management of patients with tandem lesions and the safety, efficacy of the different technical strategies available as well as their impact on the clinical outcome in these patients, to strengthen current recommendations and thus optimize patient care.
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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.