Acute Stroke Clinical Trial
Official title:
Tandem Occlusions After Emergent Stenting in Acute Ischemic Stroke
The successful recanalization is the essential standard for the tandem lesions in acute anterior ischemic stroke. However, one of the common complications after emergent carotid stenting is hemorrhagic transformation that makes the effect of this method controversial. The investigators investigated whether emergent carotid stenting achieved the improvement of clinical outcome in acute large vessel occlusion stroke.
Tandem occlusions estimated from 10% to 30% in acute anterior circulation ischemic stroke. These acute lesions had a worse prognosis with mortality rate about 50%, if the aggresive medical treatment, even intravenous thrombolysis alone was the first choice. The HERMES meta-analysis involving in mechanical thrombectomy from individual data of 5 randomized controlled trials showed benefit of mechanical thrombectomy of 122 tandem occlusions compared with medical management alone, but the endovascular treatment methods are debatable between angioplasty versus stenting at proximal extracranial carotid occlusion after successful recanalization in the intracranial segments. Multiple studies recorded recently the emergent carotid stenting was the additional option to improve cerebral blood flow which associated to favorable outcomes after acute tandem occlusions. However, there was a lack of evidence for the benefit of emergent carotid stenting in tandem occlusions in Asia. Therefore, the investigators aimed in this study to access the favorable outcomes in case of tandem occlusions treated with this procedure. ;
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