The efficacy of various interventions to the extracranial stenosis on reperfusion in anterior tandem lesions receiving mechanical thrombectomy

doi:10.16352/j.issn.1001-6325.2024.10.1388

Abstract

Abstract: Objective To evaluate the efficacy of different interventions to the extra cranial lesions in acute ischemic stroke (AIS) due to anterior tandem lesions (TL) on reperfusion. Methods As a multi-center, cross-sectional study, AIS due to anterior TL receiving mechanical thrombectomy (MT) were retrospectively collected. Interventions to the extra-cranial stenosis were recorded. Post-procedural reperfusion was assessed using the modified thrombolysis in cerebral infarction (mTICI) score. Complete revascularization was defined as mTICI 3 and good revascularization was defined as mTICI 2b/3. The relationship between different extra-cranial intervention regimens and rate of re-vascularization was compared. Results Totally 117 patients were included with 92.3% reaching good recanalization and 63.2% reaching complete re-canalization. There was no significant difference in good re-canalization rates among various extra-cranial intervention regimens. The rate of complete re-canalization was significantly higher in patients receiving endovascular therapy(P＜0.05) and there was significant difference among various endovascular treatment regimens(P＜0.01): acute balloon angioplasty only group presented the highest rate of complete re-canalization (100.0%), followed by acute stenting only group (80%), acute stenting + balloon angioplasty group (73.7%) and conservative treatment group (54.3%). Conclusions Endovascular intervention to extra-cranial stenosis contributes to complete re-canalization in AIS due to anterior TL receiving MT, and acute balloon angioplasty seems to be quite effective than acute stenting.

Key words: acute ischemic stroke, tandem lesions, stenting, balloon angioplasty, reperfusion

CLC Number:

R743.3

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