Acute Stroke, Ischemic Stroke, Acute
Conditions
Keywords
Thrombectomy, Extracranial arteries, Endovascular treatment, Antegrade approach, Retrograde approach
Brief summary
In acute ischemic stroke due to tandem occlusion, the emergent stenting has recently become an endovascular treatment option combining with mechanical thrombectomy to achieve recanalization. However, the data on the beneficial endovascular management of tandem occlusion in two circulations is still limited. The purpose of our study was to compare the improvement of clinical outcome between two circulations after emergent stenting at 3 months.
Detailed description
The posterior circulation (about 20 - 25%) is less frequent than the anterior one in the acute ischemic stroke, but high mortality and morbidity in the acute vertebrobasilar thrombosis even successful recanalization are revealed. Besides, tandem occlusion is one of the complex lesions in large vessel occlusions relating to the poor outcome, particularly in the posterior circulation. Recent studies have suggested that emergent stenting could be used as an additional treatment to achieve permanent recanalization together with mechanical thrombectomy in the intracranial segments. Permanent recanalization is one of the most important factors that impact patient outcomes after acute ischemic stroke. However, although there are various approaches for this lesion, the comparision of the effectiveness in the two circulations remains unclear. Thus, the aims of our study were to compare baseline characteristics and clinical outcome of tandem occlusions between anterior and posterior circulation after emergent stenting in extracranial arteries.
Interventions
PROCEDUREEmergent Stenting
Emergent Stenting in acute ischemic stroke caused by tandem occlusions
Sponsors
Can Tho Stroke International Services Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
19 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* Age \> 18 years old * Premorbid mRS \< 2 * NIHSS \> 5 * ASPECTS ≥ 5 or pc-ASPECTS ≥ 5
Exclusion criteria
* Onset to treatment time \> 24 hours * Loss to follow up after discharge
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The favorable 3-month outcome rate | 3 months | The favorable 3-month outcome rate was accessed by modified Rankin Score (mRS), which comprised of included good (mRS 0 - ≤ 2) and fair (mRS 3). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The symptomatic intracerebral hemorrhage rate | 24 hours after emergent stenting | The symptomatic intracerebral hemorrhage was defined as patient's intracerebral hemorrhage with postprocedural mRS ≥ 5 and there were no other evident causes for the increased modified Rankin Score (mRS). |
Countries
Vietnam
Contacts
Primary ContactCuong Tran Chi, Doctor
Backup ContactCan Tho Stroke International Services Hospital
Outcome results
None listed