Forskning
Udskriv Udskriv
Switch language
Rigshospitalet - en del af Københavns Universitetshospital
Udgivet

Carotid Stenting With Antithrombotic Agents and Intracranial Thrombectomy Leads to the Highest Recanalization Rate in Patients With Acute Stroke With Tandem Lesions

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Patient-Specific Implantation Technique to Obtain Neo-Commissural Alignment With Self-Expanding Transcatheter Aortic Valves

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Technical Considerations for Transcatheter Aortic Valve Replacement With the Navitor Transcatheter Heart Valve

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Transcatheter Treatment of Residual Significant Mitral Regurgitation Following TAVR: A Multicenter Registry

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Redo-TAVR: What About the Coronary Arteries?

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Endovascular treatment for cerebral venous sinus thrombosis - a single center study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Vector Concentration used for Stenosis Assessment in the Carotid Artery before and after Carotid Stenting

    Publikation: Bidrag til tidsskriftKonferenceartikelForskningpeer review

  3. Comparison of PED and FRED Flow Diverters for Internal Carotid Artery Aneurysms: A Propensity Score-Matched Cohort Study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

OBJECTIVES: The aim of this study was to identify the optimal endovascular approach in patients with acute stroke with tandem lesions.

BACKGROUND: At present, there is no consensus about the ideal technical strategy for the endovascular treatment of patients with acute ischemic stroke with tandem lesions of the extracranial internal carotid artery (ICA) and intracranial cerebral arteries.

METHODS: This was an international, multicenter registry with a total of 482 patients with acute ischemic stroke and tandem lesions. Patients were treated by intracranial thrombectomy as well as 1 of the following 4 strategies: 1) acute carotid artery stenting of the extracranial ICA with antithrombotic agents; 2) acute carotid artery stenting of the extracranial ICA without antithrombotic agents; 3) balloon angioplasty of the extracranial ICA; and 4) intracranial thrombectomy alone. The main outcome endpoints of the study were the degree of recanalization and the 90-day clinical outcome. The safety endpoints were symptomatic intracerebral hemorrhage and all causes of mortality at 90 days.

RESULTS: Using univariate analysis, the rates of successful reperfusion (modified Thrombolysis in Cerebral Infarction grades 2B and 3) and favorable clinical outcome after 90 days were significantly higher after acute carotid stenting with antithrombotic therapy and thrombectomy compared with the group with thrombectomy alone. After adjusting for confounding variables, acute stenting with antithrombotic therapy was independently associated with successful recanalization (odds ratio: 2.4; 95% confidence interval: 1.25 to 4.59; p = 0.008). The rates of symptomatic intracerebral hemorrhage and 90-day mortality were comparable among all 4 treatment groups.

CONCLUSIONS: Acute stenting of the extracranial ICA with antithrombotic therapy in combination with intracranial thrombectomy is associated with higher recanalization rates in treatment of patients with acute stroke with tandem lesions.

OriginalsprogEngelsk
TidsskriftJACC: Cardiovascular Interventions
Vol/bind11
Udgave nummer13
Sider (fra-til)1290-1299
Antal sider10
ISSN1936-8798
DOI
StatusUdgivet - 9 jul. 2018

ID: 56301538