دورية أكاديمية

Safety and Feasibility of Reconstructing Dissection Tandem Lesions with Flow Diverter Stents during Mechanical Thrombectomy for Acute Ischemic Stroke: A Multicenter Retrospective Case Series

التفاصيل البيبلوغرافية
العنوان: Safety and Feasibility of Reconstructing Dissection Tandem Lesions with Flow Diverter Stents during Mechanical Thrombectomy for Acute Ischemic Stroke: A Multicenter Retrospective Case Series
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
بيانات النشر: Ovid Technologies (Wolters Kluwer Health)
سنة النشر: 2022
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.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1161/svin.121.000122
DOI: 10.1161/SVIN.121.000122
الإتاحة: https://doi.org/10.1161/svin.121.000122Test
رقم الانضمام: edsbas.38C61B75
قاعدة البيانات: BASE