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[Results of endovascular treatment of acute tandem occlusion of internal carotid and middle cerebral arteries]. / Rezul'taty endovaskulyarnogo lecheniya ostroi tandemnoi okklyuzii vnutrennei sonnoi i srednei mozgovoi arterii.
Khripun, A I; Salikov, A V; Mironkov, A B; Pryamikov, A D; Asratyan, S A; Suryakhin, V S; Kamchatnov, P R; Sazhina, O A; Zakharov, K A.
Afiliación
  • Khripun AI; Pirogov Russian National Research Medical University, Moscow, Russia.
  • Salikov AV; Buyanov City Clinical Hospital, Moscow, Russia.
  • Mironkov AB; Pirogov Russian National Research Medical University, Moscow, Russia.
  • Pryamikov AD; Buyanov City Clinical Hospital, Moscow, Russia.
  • Asratyan SA; Pirogov Russian National Research Medical University, Moscow, Russia.
  • Suryakhin VS; Buyanov City Clinical Hospital, Moscow, Russia.
  • Kamchatnov PR; Buyanov City Clinical Hospital, Moscow, Russia.
  • Sazhina OA; Buyanov City Clinical Hospital, Moscow, Russia.
  • Zakharov KA; Pirogov Russian National Research Medical University, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(12. Vyp. 2): 5-10, 2020.
Article en Ru | MEDLINE | ID: mdl-33449526
OBJECTIVE: To evaluate the results of endovascular treatment of patients with ischemic stroke caused by acute tandem occlusion of the internal carotid and middle cerebral arteries (ICA and MCA). MATERIAL AND METHODS: Endovascular intervention was performed in 8 patients with tandem occlusion of ICA and MCA. The neurological deficit on admission was 17.4±5.6 NIHSS points and the average ASPECTS score was 9.5±0.8. The time from the onset of neurological symptoms to reperfusion was 224±68 min. Thrombolytic therapy was initiated before brain revascularization and continued intraoperatively in 4 out of 8 patients. ICA stenting after aspiration thrombectomy was required in 6 patients. Both antegrade (n=4) and retrograde (n=2) methods of brain revascularization were used. RESULTS: The rate of detection of tandem lesion in patients with ischemic stroke who underwent endovascular treatment was 5.4%. Technical success in restoring blood flow in the ICA basin at extra-and intra-cranial levels (mTICI 2b/3) was achieved in 7 (87.5%) patients. Intracranial hemorrhagic complications that affected the outcome of the disease were clinically significant in 25% of patients (n=2). The mortality rate was 37.5% (n=3). A satisfactory clinical result (a deficit of 0-2 mRS scores) was achieved at discharge in one of 5 surviving patients. CONCLUSION: Further studies of choosing the optimal surgical tactics for tandem occlusion of ICA and MCA, taking into account its effectiveness and safety, are need.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Revascularización Cerebral / Accidente Cerebrovascular Tipo de estudio: Observational_studies Límite: Humans Idioma: Ru Revista: Zh Nevrol Psikhiatr Im S S Korsakova Asunto de la revista: NEUROLOGIA / PSIQUIATRIA Año: 2020 Tipo del documento: Article País de afiliación: Rusia Pais de publicación: Rusia
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Revascularización Cerebral / Accidente Cerebrovascular Tipo de estudio: Observational_studies Límite: Humans Idioma: Ru Revista: Zh Nevrol Psikhiatr Im S S Korsakova Asunto de la revista: NEUROLOGIA / PSIQUIATRIA Año: 2020 Tipo del documento: Article País de afiliación: Rusia Pais de publicación: Rusia