التفاصيل البيبلوغرافية
| العنوان: |
Rendezvous intervention using combined surgical carotid endarterectomy followed by endovascular thrombectomy in patients with acute tandem occlusions: a proof-of-concept experience at a tertiary care center. |
| المؤلفون: |
Diel, Norma J., Gerner, Stefan T., Alhaj Omar, Omar, Kalder, Johannes, Manz, Enikö, Keschenau, Paula R., Struffert, Tobias, Brueckner, Thomas, Huttner, Hagen B., Doeppner, Thorsten R. |
| المصدر: |
Neurological Research & Practice; 12/7/2023, Vol. 5 Issue 1, p1-8, 8p |
| مصطلحات موضوعية: |
ENDOVASCULAR surgery, CAROTID endarterectomy, BASILAR artery, INTERNAL carotid artery, CARDIOVASCULAR surgery, TERTIARY care, PROOF of concept |
| مستخلص: |
Background: Endovascular thrombectomy (EVT) is highly effective in acute stroke patients with intracranial large vessel occlusion (LVO), however, presence of concomitant cervical occlusion of the internal carotid artery (ICA) may limit the endovascular access. This study describes feasibility and efficacy of a surgical carotid access (cutdown) to perform interdisciplinary recanalization therapy including carotid endarterectomy (CEA) followed by EVT for recanalization of intracranial LVO in stroke patients with tandem occlusions. Methods: We identified stroke patients with tandem occlusions who underwent a combined surgical-endovascular approach over a 5-year period. Surgical cutdown was provided by a cardiovascular surgery team at the angio-suite followed by EVT performed by the neuroradiological team. Demographics, stroke characteristics, treatments including antithrombotic management, procedure times, and clinical follow-up were assessed. Results: Four patients with acute stroke because of tandem occlusions received CEA followed by EVT (two patients after frustrating femoral catheterization, two as first-line approach). Successful recanalization (TICI ≥ 2b) via endovascular thrombectomy was achieved in all patients at a median of 28 min after successful surgical CEA. Intraprocedural complication was observed in one case (25%; i.e. ICA dissection). Conclusions: This small study provides evidence that a combined interdisciplinary approach of CEA followed by EVT in the angio-suite in acute stroke patients with tandem occlusions is a feasible procedure in patients otherwise not accessible to endovascular recanalizing therapy and, therefore, high likelihood of developing large hemispheric infarction. Prospective data are warranted to identify patients who benefit from this combined approach as first-line therapy. [ABSTRACT FROM AUTHOR] |
|
Copyright of Neurological Research & Practice is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
