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Carotid Artery Stenting and Intracranial Thrombectomy for Tandem Cervical and Intracranial Artery Occlusions.
Kim, Byungjun; Kim, Byung Moon; Bang, Oh Young; Baek, Jang-Hyun; Heo, Ji Hoe; Nam, Hyo Suk; Kim, Young Dae; Yoo, Joonsang; Kim, Dong Joon; Jeon, Pyoung; Baik, Seung Kug; Suh, Sang Hyun; Lee, Kyung-Yul; Kwak, Hyo Sung; Roh, Hong Gee; Lee, Young-Jun; Kim, Sang Heum; Ryu, Chang Woo; Ihn, Yon-Kwon; Jeon, Hong-Jun; Kim, Jin Woo; Byun, Jun Soo; Suh, Sangil; Park, Jeong Jin; Lee, Woong Jae; Roh, Jieun; Shin, Byoung-Soo.
Afiliación
  • Kim B; Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
  • Kim BM; Department of Radiology, Severance Hospital Stroke Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Bang OY; Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
  • Baek JH; Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
  • Heo JH; Department of Neurology, Severance Hospital Stroke Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Nam HS; Department of Neurology, Severance Hospital Stroke Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Kim YD; Department of Neurology, Severance Hospital Stroke Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Yoo J; Department of Neurology, Keimyung University Dongsan Medical center, Daegu, Republic of Korea.
  • Kim DJ; Department of Radiology, Severance Hospital Stroke Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Jeon P; Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
  • Baik SK; Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
  • Suh SH; Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Lee KY; Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Kwak HS; Department of Radiology, Chonbuk National University Medical School and Hospital, Jeonju, Republic of Korea.
  • Roh HG; Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
  • Lee YJ; Department of Radiology, Hanyang University Hospital, Seoul, Republic of Korea.
  • Kim SH; Department of Radiology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
  • Ryu CW; Department of Radiology, Kyung Hee University Gangdong Hospital, Seoul, Republic of Korea.
  • Ihn YK; Department of Radiology, St. Vincent's Hospital, Catholic University School of Medicine, Suwon, Republic of Korea.
  • Jeon HJ; Department of Neurosurgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Kore.
  • Kim JW; Department of Radiology, Inje University Ilsan Paik Hospital, Ilsan, Republic of Korea.
  • Byun JS; Department of Radiology, Chung-Ang University Hospital, Seoul, Republic of Korea.
  • Suh S; Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea.
  • Park JJ; Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
  • Lee WJ; Department of Radiology, Chung-Ang University Hospital, Seoul, Republic of Korea.
  • Roh J; Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
  • Shin BS; Department of Neurology, Chonbuk National University Medical School and Hospital, Jeonju, Republic of Korea.
Neurosurgery ; 86(2): 213-220, 2020 02 01.
Article en En | MEDLINE | ID: mdl-30848283
BACKGROUND: It remains controversial whether carotid artery stenting (CAS) is needed in cases of tandem cervical internal carotid artery occlusion (cICAO) and intracranial large vessel occlusion (LVO). OBJECTIVE: To investigate the efficacy and safety of CAS in combination with endovascular thrombectomy (CAS-EVT) in cICAO-LVO patients and to compare its outcomes with those of EVT without CAS (EVT-alone). METHODS: We identified all patients who underwent EVT for tandem cICAO-LVO from the prospectively maintained registries of 17 stroke centers. Patients were classified into 2 groups: CAS-EVT and EVT-alone. Clinical characteristics and procedural and clinical outcomes were compared between 2 groups. We tested whether CAS-EVT strategy was independently associated with recanalization success. RESULTS: Of the 955 patients who underwent EVT, 75 patients (7.9%) had cICAO-LVO. Fifty-six patients underwent CAS-EVT (74.6%), and the remaining 19 patients underwent EVT-alone (25.4%). The recanalization (94.6% vs 63.2%, P = .002) and good outcome rates (64.3% vs 26.3%, P = .007) were significantly higher in the CAS-EVT than in the EVT-alone. Mortality was significantly lower in the CAS-EVT (7.1% vs 21.6%, P = .014). There was no significant difference in the rate of symptomatic intracranial hemorrhage between 2 groups (10.7 vs 15.8%; P = .684) and according to the use of glycoprotein IIb/IIIa inhibitor (10.0% vs 12.3%; P = .999) or antiplatelet medications (10.2% vs 18.8%; P = .392). CAS-EVT strategy remained independently associated with recanalization success (odds ratio: 24.844; 95% confidence interval: 1.445-427.187). CONCLUSION: CAS-EVT strategy seemed to be effective and safe in cases of tandem cICAO-LVO. CAS-EVT strategy was associated with recanalization success, resulting in better clinical outcome.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Stents / Estenosis Carotídea / Trombectomía Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Neurosurgery Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Stents / Estenosis Carotídea / Trombectomía Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Neurosurgery Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos