دورية أكاديمية
Immediate Carotid Artery Stenting or Deferred Treatment in Patients With Tandem Carotid Lesions Treated Endovascularly for Acute Ischaemic Stroke
| العنوان: | Immediate Carotid Artery Stenting or Deferred Treatment in Patients With Tandem Carotid Lesions Treated Endovascularly for Acute Ischaemic Stroke |
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| المؤلفون: | Theodora van Elk, Louise Maes, Anne van der Meij, Robin Lemmens, Maarten Uyttenboogaart, Gert J. de Borst, Clark J. Zeebregts, Paul J. Nederkoorn |
| المصدر: | EJVES Vascular Forum, Vol 61, Iss , Pp 31-35 (2024) |
| بيانات النشر: | Elsevier, 2024. |
| سنة النشر: | 2024 |
| المجموعة: | LCC:Diseases of the circulatory (Cardiovascular) system LCC:Surgery |
| مصطلحات موضوعية: | Acute ischaemic stroke, Carotid artery, Carotid artery stenting, Endovascular thrombectomy, Large vessel occlusion, Tandem lesion, Diseases of the circulatory (Cardiovascular) system, RC666-701, Surgery, RD1-811 |
| الوصف: | Fifteen to 20% of patients with an acute ischaemic stroke have a tandem lesion defined by the combination of an intracranial large vessel thrombo-embolic occlusion and a high grade stenosis or occlusion of the ipsilateral internal carotid artery. These patients tend to have worse outcomes than patients with isolated intracranial occlusions, with higher rates of disability and death. The introduction of endovascular thrombectomy to treat the intracranial lesion clearly improved the outcome compared with treatment with intravenous thrombolysis alone. However, the best treatment strategy for managing the extracranial carotid artery lesion in patients with tandem lesions remains unknown. Current guidelines recommend carotid endarterectomy for patients with transient ischaemic attack or non-disabling stroke and moderate or severe stenosis of the internal carotid artery, within two weeks of the initial event, to prevent major stroke recurrence and death. Alternatively, the symptomatic carotid artery could be treated by endovascular placement of a stent during endovascular thrombectomy (EVT). This would negate the need for a second procedure, immediately reduce the risk of stroke recurrence, increase patient satisfaction, and could be cost effective. However, the administration of dual antiplatelet therapy could potentially increase the risk of symptomatic intracranial haemorrhage in patients with acute ischaemic stroke. Randomised controlled trials evaluating the efficacy and safety of immediate carotid artery stenting during EVT in acute stroke patients with tandem lesions are currently ongoing and will impact the current guidelines regarding the treatment of patients with acute ischaemic stroke due to these tandem lesions. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2666-688X 71378731 |
| العلاقة: | http://www.sciencedirect.com/science/article/pii/S2666688X23000941Test; https://doaj.org/toc/2666-688XTest |
| DOI: | 10.1016/j.ejvsvf.2023.12.002 |
| الوصول الحر: | https://doaj.org/article/d713787310b7469ebc1dcae2ec7de30dTest |
| رقم الانضمام: | edsdoj.713787310b7469ebc1dcae2ec7de30d |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 2666688X 71378731 |
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| DOI: | 10.1016/j.ejvsvf.2023.12.002 |