المؤلفون: Rodrigo-Gisbert, Marc, García-Tornel, Alvaro, Requena, Manuel, Vielba-Gómez, Isabel, Bashir, Saima, Rubiera, Marta, De Dios Lascuevas, Marta, Olivé-Gadea, Marta, Piñana, Carlos, Rizzo, Federica, Muchada, Marian, Rodriguez-Villatoro, Noelia, Rodríguez-Luna, David, Juega, Jesus, Pagola, Jorge, Hernández, David, Molina, Carlos A., Terceño, Mikel, Tomasello, Alejandro, Ribo, Marc

المساهمون: Fundació Institut de Recerca Hospital Universitari Vall d’Hebron

المصدر: Scientific Reports ; volume 14, issue 1 ; ISSN 2045-2322

مصطلحات موضوعية: Multidisciplinary

الوصف: The identification of large vessel occlusion with underlying intracranial atherosclerotic disease (ICAS-LVO) before endovascular treatment (EVT) continues to be a challenge. We aimed to analyze baseline clinical-radiological features associated with ICAS-LVO that could lead to a prompt identification. We performed a retrospective cross-sectional study of consecutive patients with stroke treated with EVT from January 2020 to April 2022. We included anterior LVO involving intracranial internal carotid artery and middle cerebral artery. We analyzed baseline clinical and radiological variables associated with ICAS-LVO and evaluated the diagnostic value of a multivariate logistic regression model to identify ICAS-LVO before EVT. ICAS-LVO was defined as presence of angiographic residual stenosis or a trend to re-occlusion during EVT procedure. A total of 338 patients were included in the study. Of them, 28 patients (8.3%) presented with ICAS-LVO. After adjusting for confounders, absence of atrial fibrillation (OR 9.33, 95% CI 1.11–78.42; p = 0.040), lower hypoperfusion intensity ratio (HIR [Tmax > 10 s/Tmax > 6 s ratio], (OR 0.69, 95% CI 0.50–0.95; p = 0.025), symptomatic intracranial artery calcification (IAC, OR .15, 95% CI 1.64–26.42, p = 0.006), a more proximal occlusion (ICA, MCA-M1: OR 4.00, 95% CI 1.23–13.03; p = 0.021), and smoking (OR 2.91, 95% CI 1.08–7.90; p = 0.035) were associated with ICAS-LVO. The clinico-radiological model showed an overall well capability to identify ICAS-LVO (AUC = 0.88, 95% CI 0.83–0.94; p < 0.001). In conclusion, a combination of clinical and radiological features available before EVT can help to identify an ICAS-LVO. This approach could be useful to perform a rapid assessment of underlying etiology and suggest specific pathophysiology-based measures. Prospective studies are needed to validate these findings in other populations.

الإتاحة: https://doi.org/10.1038/s41598-024-53354-zTest
https://www.nature.com/articles/s41598-024-53354-z.pdfTest
https://www.nature.com/articles/s41598-024-53354-zTest

المؤلفون: Juega, Jesus, Li, Jiahui, Palacio-Garcia, Carlos, Rodriguez, Maite, Tiberi, Riccardo, Piñana, Carlos, Rodriguez-Luna, David, Requena, Manuel, García-Tornel, Álvaro, Rodriguez-Villatoro, Noelia, Rubiera del Fueyo, Marta A, Muchada, Marian, Olivé-Gadea, Marta, Rizzo, Federica, Hernandez, David, Dios-Lascuevas, Marta, Hernández-Pérez, María, Dorado Bouix, Laura, Quesada, Helena, Cardona, Pere-Joan, De La Torre, Carolina, Gallur, Laura, Camacho, Jessica, Ramón y Cajal, Santiago, Tomasello, Alejandro, Ribo, Marc, Molina, Carlos A., Pagola, Jorge, Universitat Autònoma de Barcelona

مصطلحات موضوعية: Acute stroke, Flow cytometry, Granulocytes, Mechanical thrombectomy, Recanalization, Thrombi

الوصف: Altres ajuts: acords transformatius de la UAB ; We aim to identify a profile of intracranial thrombus resistant to recanalization by mechanical thrombectomy (MT) in acute stroke treatment. The first extracted clot of each MT was analyzed by flow cytometry obtaining the composition of the main leukocyte populations: granulocytes, monocytes, and lymphocytes. Demographics, reperfusion treatment, and grade of recanalization were registered. MT failure (MTF) was defined as final thrombolysis in cerebral infarction score IIa or lower and/or need of permanent intracranial stenting as a rescue therapy. To explore the relationship between stiffness of intracranial clots and cellular composition, unconfined compression tests were performed in other cohorts of cases. Thrombi obtained in 225 patients were analyzed. MTF were observed in 30 cases (13%). MTF was associated with atherosclerosis etiology (33.3% vs. 15.9%; p = 0.021) and higher number of passes (3 vs. 2; p < 0.001). Clot analysis of MTF showed higher percentage of granulocytes [82.46 vs. 68.90% p < 0.001] and lower percentage of monocytes [9.18% vs.17.34%, p < 0.001] in comparison to successful MT cases. The proportion of clot granulocytes (aOR 1.07; 95% CI 1.01-1.14) remained an independent marker of MTF. Among thirty-eight clots mechanically tested, there was a positive correlation between granulocyte proportion and thrombi stiffness (Pearson's r = 0.35, p = 0.032), with a median clot stiffness of 30.2 (IQR, 18.9-42.7) kPa. Granulocytes-rich thrombi are harder to capture by mechanical thrombectomy due to increased stiffness, so a proportion of intracranial granulocytes might be useful to guide personalized endovascular procedures in acute stroke treatment. Supplementary Information: The online version contains supplementary material available at 10.1007/s13311-023-01385-1.

وصف الملف: application/pdf

العلاقة: Neurotherapeutics; Vol. 20 (may 2023), p. 1167-1176; https://ddd.uab.cat/record/282876Test; urn:10.1007/s13311-023-01385-1; urn:oai:ddd.uab.cat:282876; urn:pmcid:PMC10457261; urn:pmc-uid:10457261; urn:pmid:37212981; urn:oai:pubmedcentral.nih.gov:10457261; urn:articleid:18787479v20p1167; urn:oai:egreta.uab.cat:publications/9d613ef3-24b9-4428-aea2-f54b08860760

الإتاحة: https://ddd.uab.cat/record/282876Test

المؤلفون: Piñana, Carlos, Remollo, Sebastian, Zamarro, Joaquín, Werner, Mariano, Espinosa de Rueda, Mariano, Vega, Pedro, Hernandez, David, Murias, Eduardo, Rivera, Eila, Olier, Jorge, San Roman, Luis, Páez-Carpio, Alfredo, Requena, Manuel, Aixut, Sonia, de Dios Lascuevas, Marta, Moreu, Manuel, Rosati, Santiago, Gramegna, Laura Ludovica, Castaño, Carlos, Tomasello, Alejandro

مصطلحات موضوعية: New devices and techniques

الوصف: Background Flow diverters have emerged in recent years as a safe and effective treatment for intracranial aneurysms, with expanding indications. The Derivo embolization device (DED) is a second-generation flow diverter with a surface finish that may reduce thrombogenicity. We report our multicenter experience evaluating its safety and efficacy. Methods We retrospectively analyzed all patients treated with the DED in eight centers in Spain between 2016 and 2020. Demographics, clinical data, procedural complications, morbidity and aneurysm occlusion rates were collected. Results A total of 209 patients with 250 aneurysms were treated (77.5% women). The majority of aneurysms were located in the internal carotid artery (86.8%) and most (69.2%) were small (<10 mm) with a median maximum diameter of 5.85 mm and median neck size of 4 mm. DED deployment was successful in all cases, despite two malfunctioning devices (1%). Major complications occurred in nine patients (4.3%), while mild neurologic clinical events were registered in 23 (11%); four patients died (1.9%). A total of 194 aneurysms had an angiographic follow-up at 6 months and showed complete aneurysm occlusion in 75% of cases. Twelve-month follow-up was available for 112 of the treated aneurysms, with a total occlusion rate of 83%. Conclusion The DED is a second-generation surface-modified flow diverter that presents an option for treatment of intracranial aneurysms with comparable safety and efficacy to other available flow diverter devices. Nonetheless, risks are not negligible, and must be balanced against the natural history risk of cerebral aneurysms, considering the tendency to widen indications for treatment of smaller and less complex lesions in day-to-day use.

وصف الملف: text/html

العلاقة: http://jnis.bmj.com/cgi/content/short/15/9/871Test; http://dx.doi.org/10.1136/jnis-2022-019220Test

الإتاحة: https://doi.org/10.1136/jnis-2022-019220Test
http://jnis.bmj.com/cgi/content/short/15/9/871Test

المؤلفون: Juega, Jesus, Requena, Manuel, Piñana, Carlos, Rodriguez, Maite, Camacho, Jessica, Vidal, Marta, Moliné, Teresa, Serna, Garazi, Palacio-Garcia, Carlos, Rubiera, Marta, Garcia-Tornel, Alvaro, Rodriguez-Villatoro, Noelia, Rodriguez-Luna, David, Muchada, Marian, Olive Gadea, Marta, Rizzo, Federica, Rodrigo-Gisbert, Marc, Lazaro, Carlos, Hernandez, David, de Dios Lascuevas, Marta, Diana, Francesco, Dorado, Laura, Hernández-Pérez, María, Quesada, Helena, Cardona Portela, Pere, De La Torre, Carolina, Ramon-y-Cajal, Santiago, Tomasello, Alejandro, Ribo, Marc, Molina, Carlos A, Pagola, Jorge

المساهمون: Fundació la Marató de TV3

المصدر: Journal of NeuroInterventional Surgery ; page jnis-2024-021654 ; ISSN 1759-8478 1759-8486

الوصف: Background The impact of thrombolytics directed towards different thrombus components regarding site of occlusion in combination with mechanical thrombectomy (MT) to achieve endovascular complete recanalization is unclear. Methods Retrospective analysis of a prospective database in two stroke centers. Intracranial thrombi retrieved by MT were analyzed using hematoxylin–eosin staining for fibrin and red blood cell proportions, and CD61 immunostaining for platelets proportion in thrombus (PLTPT) assessment. Thrombi composition, baseline variables, etiology, treatment features and occlusion location were analyzed. Results Overall, 221 patients completed the per protocol analysis and 110 cases achieved a final expanded Thrombolysis in Cerebral Infarction (eTICI) 3 (49%) of which 70 were MT (32%) by first pass effect (FPE). Thrombi from medium distal vessel occlusions had higher PLTPT compared with thrombi from proximal large vessel occlusions (68% vs 61%, P=0.026). In particular, middle cerebral artery M2–M3 segment thrombi had the highest PLTPT (70%), and basilar artery thrombi the lowest PLTPT (41%). After logistic regression analysis adjusted for occlusion location and intravenous fibrinolysis, lower baseline National Institutes of Health Stroke Scale score (adjusted OR (aOR) 0.95, 95% CI 0.913 to 0.998) and PLTPT (aOR 0.97, 95% CI 0.963 to 0.993) were independently associated with FPE. Fewer MT passes (aOR 0.67, 95% CI 0.538 to 0.842) and platelet poor thrombus (<62% PLTPT; aOR 2.39, 95% CI 1.288 to 4.440) were independently associated with final eTICI 3. Conclusions Occlusion location might be a surrogate parameter for thrombus composition. Platelet poor clots and fewer MT passes were independently associated with complete endovascular recanalization. Clinical trials testing the benefits of combining selective intra-arterial platelet antagonists with MT to improve endovascular outcomes are warranted.

الإتاحة: https://doi.org/10.1136/jnis-2024-021654Test

المؤلفون: Rodríguez, Isabel, Gramegna, Laura Ludovica, Requena, Manuel, Rizzuti, Michele, Elosua, Iker, Mayol, Jordi, Olivé-Gadea, Marta, Diana, Francesco, Rodrigo-Gisbert, Marc, Muchada, Marián, Rivera, Eila, García-Tornel, Álvaro, Rizzo, Federica, De Dios, Marta, Rodríguez-Luna, David, Piñana, Carlos, Pagola, Jorge, Hernández, David, Juega, Jesús, Rodríguez, Noelia, Quintana, Manuel, Molina, Carlos, Ribo, Marc, Tomasello, Alejandro

المصدر: Interventional Neuroradiology ; ISSN 1591-0199 2385-2011

مصطلحات موضوعية: General Medicine

الوصف: Background Symptomatic carotid artery stenosis is a significant contributor to ischemic strokes. Carotid artery stenting (CAS) is usually indicated for secondary stroke prevention. This study evaluates the safety and efficacy of CAS performed within a short time frame from symptom onset. Methods We conducted a single-center, retrospective study of consecutive patients who underwent CAS for symptomatic carotid stenosis within eight days of symptom onset from July 2019 to January 2022. Data on demographics, medical history, procedural details, and follow-up outcomes were analyzed. The primary outcome measure was the recurrence of the stroke within the first month post-procedure. Secondary outcomes included mortality, the rate of intra-procedural complications, and hyperperfusion syndrome. Results We included 93 patients with a mean age of 71.7 ± 11.7 years. The median time from symptom onset to CAS was 96 h. The rate of stroke recurrence was 5.4% in the first month, with a significant association between the number of stents used and increased recurrence risk. Mortality within the first month was 3.2%, with an overall mortality rate of 11.8% after a median follow-up of 19 months. Intra-procedural complications were present in five (5.4%) cases and were related to the number of stents used ( p = 0.002) and post-procedural angioplasty ( p = 0.045). Hyperperfusion syndrome occurred in 3.2% of cases. Conclusion Early CAS within the high-risk window post-symptom onset is a viable secondary stroke prevention strategy in patients with symptomatic carotid artery stenosis. The procedure rate of complication is acceptable, with a low recurrence of stroke. However, further careful selection of patients for this procedural strategy is crucial to optimize outcomes.

الإتاحة: https://doi.org/10.1177/15910199241239204Test

المؤلفون: Hernandez Morales, David, Requena, Manuel, de Dios Lascuevas, Marta, Olive-Gadea, Marta, Gramegna, Laura L, Muchada, Marian, Rivera, Eila, Garcia-Tornel, Alvaro, Rizzo, Federica, Piñana, Carlos, Rodriguez-Luna, David, Pagola, Jorge, Diana, Francesco, Juega, Jesus M, Rodriguez-Villatoro, Noelia, Rubiera, Marta, Molina, Carlos A, Ribo, Marc, tomasello, alejandro

المصدر: Stroke ; volume 55, issue Suppl_1 ; ISSN 0039-2499 1524-4628

الوصف: Introduction: Femoral artery is the most used access for mechanical thrombectomy (MT) in stroke patients with a large vessel occlusion. Routine radial access has been proposed as an alternative following cardiology guidelines although its safety and efficacy remain controversial. Hypothesis: Radial access for MT is non-inferior to femoral access in terms of final recanalization. Methods: The study was an investigator-initiated, single-center, evaluator-blinded randomized clinical trial. Stroke patients undergoing MT, with femoral artery patency and radial artery diameter ≥2.5mm were randomly assigned (1:1) to either radial (60 patients) or femoral access (60 patients). The primary binary outcome was successful recanalization (final eTICI score 2b-3) assigned by blinded evaluators. In the per protocol analysis, patients with allocated access failure were considered non-recanalized. We established a non-inferiority margin of -13.2%, considering an acceptable reduction of 15% in the expected recanalization rates. Results: From September 2021 to July 2023, 120 patients were randomly assigned and 114 (57 radial access, 57 femoral access) with confirmed intracranial occlusion on initial angiogram were included in the primary analysis. In the intention to treat analysis, successful recanalization was achieved in 48/57 (84.2%) patients assigned to femoral access and in 54/57(94.7%) patients assigned to radial (adjusted risk difference 3.36%, 95% CI –6.47% to 13%; p<0.001). The lower limit of one-sided 95% CI was –4.8%, which did not cross our predefined margin of -13.2%. Median time from angiography suite arrival to first pass (femoral: 30 (IQR 25-37) minutes versus radial: 41 (IQR 33-62) minutes, p<0.001) and from suite arrival to recanalization (femoral: 42 (IQR 28-74) versus radial: 59.5 (IQR 44-81) minutes, p<0.050) were longer after radial access. Both groups presented one severe access complication and there was no difference in the rate of allocated access failure: radial 6 (10.5%) radial Vs femoral 5 ...

الإتاحة: https://doi.org/10.1161/str.55.suppl_1.81Test

المؤلفون: Hernandez, David, Requena, Manuel, Olivé-Gadea, Marta, de Dios, Marta, Gramegna, Laura Ludovica, Muchada, Marian, García-Tornel, Álvaro, Diana, Francesco, Rizzo, Federica, Rivera, Eila, Rubiera, Marta, Piñana, Carlos, Rodrigo-Gisbert, Marc, Rodríguez-Luna, David, Pagola, Jorge, Carmona, Tomás, Juega, Jesús, Rodríguez-Villatoro, Noelia, Molina, Carlos, Ribo, Marc, Tomasello, Alejandro

المصدر: Stroke ; volume 55, issue 4, page 840-848 ; ISSN 0039-2499 1524-4628

الوصف: BACKGROUND: Transfemoral access is predominantly used for mechanical thrombectomy in patients with stroke with a large vessel occlusion. Following the interventional cardiology guidelines, routine transradial access has been proposed as an alternative, although its safety and efficacy remain controversial. We aim to explore the noninferiority of radial access in terms of final recanalization. METHODS: The study was an investigator-initiated, single-center, evaluator-blinded, noninferiority randomized clinical trial. Patients with stroke undergoing mechanical thrombectomy, with a patent femoral artery and a radial artery diameter ≥2.5 mm, were randomly assigned (1:1) to either transradial (60 patients) or transfemoral access (60 patients). The primary binary outcome was the successful recanalization (expanded Treatment in Cerebral Ischemia score, 2b–3) assigned by blinded evaluators. We established a noninferiority margin of −13.2%, considering an acceptable reduction of 15% in the expected recanalization rates. RESULTS: From September 2021 to July 2023, 120 patients were randomly assigned and 116 (58 transradial access and 58 transfemoral access) with confirmed intracranial occlusion on the initial angiogram were included in the intention-to-treat analysis. Successful recanalization was achieved in 51 (87.9%) patients assigned to transfemoral access and in 56/58 (96.6%) patients assigned to transradial (adjusted 1 side risk difference [RD], −5.0% [95% CI, −6.61% to +13.1%]) showing noninferiority of transradial access. Median time from angiosuite arrival to first pass (femoral, 30 [interquartile range, 25–37] minutes versus radial: 41 [interquartile range, 33–62] minutes; P <0.001) and from angiosuite arrival to recanalization (femoral: 42 (IQR, 28–74) versus radial: 59.5 (IQR, 44–81) minutes; P <0.050) were longer in the transradial access group. Both groups presented 1 severe access complication and there was no difference in the rate of access conversion: transradial 7 (12.1%) versus transfemoral 5 ...

الإتاحة: https://doi.org/10.1161/strokeaha.124.046360Test

المؤلفون: Hernández, David, Serrano, Elena, Molins, Gemma, Zarco, Federico, Chirife, Oscar, Werner, Mariano, Lara, Blanca, Ramos Triguero, Anna, Llull, Laura, Requena, Manuel, Dios las Cuevas, Marta de, Remollo, Sebastián, Piñana, Carlos, López Rueda, Antonio

المصدر: Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

مصطلحات موضوعية: Oclusions arterials, Cirurgia vascular, Arterial occlusions, Vascular surgery

الوصف: The purpose of this study is to evaluate the best endovascular approach (aspiration or stent-retriever) and the impact of stent retriever size and length on clinical and angiographic outcomes in patients with acute intracranial ICA occlusion. We conducted a retrospective analysis of a prospective database of consecutive patients with acute intracranial ICA occlusion undergoing endovascular treatment in four Comprehensive Stroke Center between June-2019 and December-2020. We include 121 patients; Stent-retriever (SR) was used as first technical approach in 107 patients (88.4%) and aspiration was used in 14 patients (11.6%). SR group had higher rate of FPE compared to aspiration group (29 vs. 0%, p = 0.02). In SR subgroup, treatment highlighted higher FPE in the 6 x 50 SR (37.7%), than in the rest of the SR which are 21.2% (4-5 mm size and 20-50 mm length SR) and 19% (6 mm size and 25-40 mm length SR), but it was not found to be statistically significant. There were no other significant differences across the groups regarding primary angiographic or clinical outcomes. In our intracranial ICA occlusion series, stent retrievers were superior to direct aspiration in obtaining FPEs and mFPEs, and longer devices achieved better results with no statistically significant difference. Further studies evaluating the effects of different ICA clot removal approaches are warranted to confirm these results.

وصف الملف: 6 p.; application/pdf

العلاقة: Reproducció del document publicat a: https://doi.org/10.3389/fneur.2022.925159Test; Frontiers in Neurology, 2022, vol.13, num. 925159; https://doi.org/10.3389/fneur.2022.925159Test; http://hdl.handle.net/2445/188701Test

الإتاحة: https://doi.org/10.3389/fneur.2022.925159Test
http://hdl.handle.net/2445/188701Test

المؤلفون: Requena, Manuel, Piñana, Carlos, Olive-Gadea, Marta, Hernández, David, Boned, Sandra, De Dios, Marta, Rodrigo, Marc, Rivera, Eila, Muchada, Marián, Cuevas, José Luis, Rubiera, Marta, García-Tornel, Álvaro, Gramegna, Laura Ludovica, Molina, Carlos, Ribo, Marc, Tomasello, Alejandro

المصدر: Interventional Neuroradiology ; volume 29, issue 5, page 504-509 ; ISSN 1591-0199 2385-2011

مصطلحات موضوعية: General Medicine

الوصف: Introduction Mechanical thrombectomy (MT) with combined treatment including both a stent retriever and distal aspiration catheter may improve recanalization rates in patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO). Here, we evaluated the effectiveness and safety of the REACT aspiration catheter used with a stent retriever. Methods This prospective study included consecutive adult patients who underwent MT with a combined technique using REACT 68 and/or 71 between June 2020 and July 2021. The primary endpoints were final and first pass mTICI 2b-3 and mTICI 2c-3 recanalization. Analysis was performed after first pass and after each attempt. Secondary safety outcomes included procedural complications, symptomatic intracranial hemorrhage (sICH) at 24 h, in-hospital mortality, and 90-day functional independence (modified Rankin Scale [mRS] 0–2). Results A total of 102 patients were included (median age 78; IQR: 73–87; 50.0% female). At baseline, median NIHSS score was 19 (IQR: 11–21), and ASPECTS was 9 (IQR: 8–10). Final mTICI 2b-3 recanalization was achieved in 91 (89.2%) patients and mTICI 2c-3 was achieved in 66 (64.7%). At first pass, mTICI 2b-3 was achieved in 55 (53.9%) patients, and mTICI 2c-3 in 37 (36.3%). The rate of procedural complications was 3.9% (4/102), sICH was 6.8% (7/102), in-hospital mortality was 12.7% (13/102), and 90-day functional independence was 35.6% (36/102). Conclusion A combined MT technique using a stent retriever and REACT catheter resulted in a high rate of successful recanalization and first pass recanalization in a sample of consecutive patients with AIS due to LVO in clinical use.

الإتاحة: https://doi.org/10.1177/15910199221095798Test

المؤلفون: Diaz‐Silva, Humberto, Piñana, Carlos, Gramegna, Laura Ludovica, Requena, Manuel, Rivera, Eila, González, Eva María, Fondevila Monsó, Juan José, Chirife, Oscar, Moreu, Manuel, Vega, Pedro, Remollo, Sebastià, Martínez, Mario, Galván, Jorge, Schuller, Miguel, Cirillo, Luigi, Hernández, David, Ribo, Marc, Tomasello, Alejandro

المصدر: Stroke: Vascular and Interventional Neurology ; volume 2, issue 1 ; ISSN 2694-5746

الوصف: Background Patients with acute ischemic stroke due to large vessel occlusion may present with concomitant carotid dissections that make the technical approach for their treatment challenging. The purpose of this study was to determine the safety and feasibility of flow diverter (FD) stents to treat carotid artery dissections in tandem lesions of acute ischemic stroke patients during mechanical thrombectomy. Methods A retrospective review of all patients in which a carotid artery dissection was treated with an FD during endovascular treatment of acute ischemic stroke between 2018 and 2020 was conducted in 5 high‐volume Comprehensive Stroke Centers. Patient clinical and angiographical characteristics, postoperative outcome, and follow‐up were recorded. Results A total of 12 patients (mean age: 54.18±14.74 years, median Alberta Stroke Program Early CT Score: 10 [interquartile range 9–10]) were included. Successful FD stenting with immediate patency of the dissected segments and successful intracranial recanalization modified thrombolysis in cerebral infarction score 2b‐3 after thrombectomy was achieved in all patients. A good outcome (modified Rankin scale 0–2 at 90 days) was achieved in 66% (8/12) of patients. In 25% (3/12) of patients, an additional self‐expanding carotid stent was used to anchor the FD proximally at the carotid bulb level. Complications included 1 symptomatic intracranial hemorrhage after procedure (24–48 hours) and 2 in‐stent stenoses at follow‐up. Conclusions In this small case series, the treatment of carotid artery dissection with FD stents was safe and technically feasible during mechanical thrombectomy of acute ischemic stroke patients with tandem lesions and resulted in a high rate of good clinical outcome. These results may provide the basis for designing larger prospective studies to assess the efficacy and safety of FD stents in selected patients with carotid tandem lesions.

الإتاحة: https://doi.org/10.1161/svin.121.000122Test