ArticleJournal of neurosurgery2024
Endovascular treatment of acute ischemic stroke patients with tandem lesions: antegrade versus retrograde approach.
Article in Journal of neurosurgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Microcatheter delivery of embolic protection devices for acute atherosclerotic tandem occlusion: patient series.Journal of neurosurgery. Case lessons · 2025Article
- Effect of the Cervical Lesion Severity on Procedural and Clinical Outcomes after Endovascular Treatment of Acute Tandem Lesions: A Multicenter Study.Stroke (Hoboken, N.J.) · 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
- Commentary: 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
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Authors and funding
36 authors.
Funding
Abstract
objectiveThe optimal technique for treating tandem lesions (TLs) with endovascular therapy is debatable. The authors evaluated the functional, safety, and procedural outcomes of different approaches in a multicenter study.
methodsAnterior circulation TL patients treated from January 2015 to December 2020 were divided on the basis of antegrade versus retrograde approach and included. The evaluated outcomes were favorable modified Rankin Scale (mRS) score (mRS score 0-2) at 3 months, ordinal shift in mRS score, successful recanalization, excellent recanalization, first-pass effect (FPE), time from groin puncture to successful recanalization, symptomatic intracranial hemorrhage (sICH), and 90-day mortality.
resultsAmong 691 patients treated at 16 centers, 286 patients (174 antegrade and 112 retrograde approach patients) with acute stenting were included in the final analysis. There were no significant differences in mRS score 0-2 at 90 days (52.2% vs 50.0%, adjusted odds ratio [aOR] 0.83, 95% CI 0.42-1.56, p = 0.54), favorable shift in 90-day mRS score (aOR 1.03, 95% CI 0.66-1.29, p = 0.11), sICH (4.0% vs 4.5%, aOR 0.64, 95% CI 0.24-1.51, p = 0.45), successful recanalization (89.4% vs 93%, aOR 0.49, 95% CI 0.19-1.28, p = 0.19), excellent recanalization (51.4% vs 58.9%, aOR 0.59, 95% CI 0.40-1.07, p = 0.09), FPE (58.3% vs 69.7%, aOR 0.62, 95% CI 0.44-1.15, p = 0.21), and mortality at 90 days (16.6% vs 14.0%, aOR 0.94, 95% CI 0.35-2.44, p = 0.81) between the groups. The median (interquartile range) groin puncture to recanalization time was significantly longer in the antegrade group (59 [43-90] minutes vs 49 [35-73] minutes, p = 0.036).
conclusionsThe retrograde approach was associated with faster recanalization times with a similar functional and safety profile when compared with the antegrade approach in patients with acute ischemic stroke with TL.
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