Carotid artery stenting during endovascular thrombectomy for acute ischemic stroke with tandem occlusion: the Italian Registry of Endovascular Treatment in Acute Stroke

Mascolo, Alfredo Paolo; Marrama, Federico; Koch, Giacomo; D’Agostino, Federica; Rocco, Alessandro Di; Wlderk, Andrea; Nezzo, Marco; Argirò, Renato; Carità, Giuseppe; Paolucci, Matteo; Genovese, Antonio; Franchini, Enrica; Liberto, Alessandra Di; Ricciardi, Giuseppe; Petruzzellis, Marco; Ruiz, Luigi; Ciccone, Alfonso; Thyrion, F. Zappoli; Pracucci, Giovanni; Gandini, Roberto; Ros, Valerio Da; Greco, Laura; Morosetti, Daniele; Diomedi, Marina; Sallustio, Fabrizio; Mangiafico, Salvatore; Nappini, Sergio; Limbucci, Nicola; Renieri, Leonardo; Fainardi, Enrico; Inzitari, Domenico; Nencini, Patrizia; Vallone, Stefano; Verganti, Luca; Sacchetti, Federico; Zelent, Gabriele; Bigliardi, Guido; Dell’Acqua, Maria Luisa; Picchetto, Livio; Vandelli, Laura; Pentore, Roberta; Maffei, Stefania; Nichelli, Paolo Frigio; Longo, Marcello; Pitrone, Antonio; Vinci, Sergio Lucio; Velo, Mariano; Caragliano, Antonio Armando; Tessitore, Agostino; Bonomo, O.; Musolino, Rossella; Spina, Paolino La; Casella, Carmela; Fazio, Maria; Grillo, Francesco; Cotroneo, Masina; Dell’Aera, Cristina; Francalanza, Isabella; Bracco, Sandra; Cioni, Samuele; Gennari, Paola; Vallone, Ignazio Maria; Cerase, Alfonso; Tassi, Rossana; Martini, Giuseppe; Bergui, Mauro; Stura, G.; Daniele, D.; Cerrato, Paolo; Naldi, Andrea; Saletti, Andrea; Marcello, Onofrio; Vito, Alessandro De; Azzini, Cristiano; Casetta, Ilaria; Gasparotti, Roberto; Mardighian, Dikran; Frigerio, Michele; Magoni, Mauro; Costa, A.; Simonetti, L.; Cirillo, Luigi; Taglialatela, Francesco; Isceri, Salvatore; Princiotta, Ciro; Dall’Olio, M; Cellerini, M.; Zini, Andrea; Piccolo, L.; Migliaccio, Ludovica; Brancaleoni, L.; Naldi, F.; Romoli, Michele; Zaniboni, Alberto; Ruggiero, Maria; Haznedari, Nicolò; Commodaro, Christian; Longoni, Marco; Biguzzi, Sara; Cordici, Francesco; Malatesta, Emanuele; Castellan, Lucio; Mavilio, N.; Salsano, Giancarlo; Malfatto, Laura; Finocchi, Cinzia; Menozzi, Roberto; Piazza, Paolo; Epifani, Enrico; A, Andreone; Scoditti, Umberto; Castellini, Paola; Latte, L.; Grisendi, Ilaria; Cosottini, Mirco; Puglioli, Michele; Lazzarotti, G; Lauretti, Dario Luca; Mancuso, Michelangelo; Giannini, Nicola; Maccarone, M.; Orlandi, Giovanni; Comai, Alessio; Bonatti, Giampietro; Nano, G.; Ferro, Federica; Bonatti, Matteo; Dall’Ora, Elisa; Dossi, Roberto Currò; Turri, E.; Turri, Mara; Pedicelli, Alessandro; D’Argento, Francesco; Alexandre, Andrea; Frisullo, Giovanni; Egidio, V. Di; Puglielli, Edoardo; Ruggero, L.; Assetta, Maurizio; Casalena, Alfonsina; Causin, Francesco; Cester, Giacomo; Baracchini, Claudio; Viaro, Federica; Pieroni, Alessio; Vaudano, Giacomo Paolo; Comelli, Chiara; Maggio, Luca; Castellano, Davide; Cavallo, R; Duc, Enrica; Chianale, Gigliola; Ciceri, Elisa; Plebani, Mauro; Augelli, Raffaele; Zampieri, P.; Grazioli, Andrea; Cappellari, Manuel; Forlivesi, Stefano; Tomelleri, Giampaolo; Micheletti, Nicola; Chiumarulo, Luigi; Zimatore, Domenico Sergio; Federico, Francesco; Petruzzelli, Marco; Zappoli, F.; Lafe, Elvis; Sanfilippo, Giuseppina; Sgreccia, Alessandro; Martignoni, Alessandra; Cavallini, Anna; Denaro, F.; Persico, Alessandra; Cagliari, Enrico; Cavasin, Nicola; Quatrale, R.; Critelli, Adriana; Burdi, Nicola; Semeraro, Vittorio; Lucarelli, Nicola Maria; Ganimede, Maria Porzia; Internò, S.; Tinelli, Andrea; Prontera, Maria Pia; Pesare, Angela; Cotroneo, Enrico; Pampana, Enrico; Ricciardi, Fabrizio; Gigli, R.; Pezzella, Francesca Romana; Corsi, Fabio; Giorgianni, Andrea; Baruzzi, Fabio; Pellegrino, C.; Terrana, Alberto; Versino, Maurizio; DeLodovici, Maria Luisa; Carimati, Federico; Cariddi, Lucia Princiotta; Auteri, William; Benedetto, Olindo Di; Silvagni, Umberto; Perrotta, Paolo; Crispino, Emanuela; Petrone, Alfredo; Stancati, Furio; Rizzuto, Stefano; Pugliese, Pierfrancesco; Pisani, Ermanno; Siniscalchi, Antonio; Gaudiano, Carmen; Pirritano, Domenico; Giudice, Francesco Del; Piano, Mariangela; Agostoni, Elio; Motto, Cristina; Gatti, A; Guccione, Angelo; Tortorella, Rachele; Stecco, Alessandro; Guzzardi, Giuseppe; Sette, Bruno Del; Coppo, Lorenzo; Baldan, J.; Romano, Daniele; Siani, A.; Locatelli, G.; Saponiero, Renato; Napolitano, R.; Gregorio, M. De; Volpe, G.; Tenuta, M.; Guidetti, Giulio; Biraschi, Francesco; Wulbek, A.; Toni, Danilo; Falcou, Anne; Anzini, A.; Mancini, Alessandra; Michele, Manuela De; Fausti, Silvia; Mascio, Maria Teresa Di; Durastanti, L.; Sbardella, Emilia; Mellina, Vittorio; Nicolini, Ettore; Comelli, Simone; Ganau, C.; Corraine, Simona; Fusaro, Federico; Ferrari, Antonio; Schirru, Federica; Ledda, V.; Secci, S.; Melis, Maurizio; Piras, Valeria; Moller, Jessica; Padolecchia, Riccardo; Allegretti, L.; Caldiera, Valentina; Calia, Stefano; Ganci, Giuseppe; Tassinari, Tiziana; Saia, Valentina; Sugo, Annalisa; Nicola, M. De; Giannoni, Mirko; Bruni, Stefano; Gambelli, Elena; Provinciali, Leandro; Nuzzi, Nunzio Paolo; Marcheselli, Simona; Corato, M. Di; Scomazzoni, Francesco; Simionato, F.; Roveri, Luisa; Filauri, Pietro; Orlandi, B.; Santis, Federica De; Tiseo, Cindy; Notturno, F.; Ornello, R.; Pavia, Marco; Squassina, Guido; Cobelli, Milena; Morassi, Mauro; Magni, E.; Invernizzi, Paolo; Pepe, Fulvio; Bigni, Barbara; Costa, Paolo; Crabbio, Massimo; Griffini, Simona; Palmerini, Francesco; Piras, Maria Paola; Gallesio, Ivan; Stefano, Barbero; Ferrandi, Delfina; Dui, Giovanni; Fancello, Maria; Zedda, Sandro; Ticca, Anna; Saddi, Maria Valeria; Deiana, Gianluca; Rossi, Rosanna; Carboni, Nicola; Mela, A.; Amistà, Pietro; Russo, Marco; Gentile, Mauro; Iannucci, Giuseppe; Pinna, V.; Clemente, Loris Di; Santi, M.; Boni, Antonella; Luca, Cristina De; Natrella, Massimiliano; Fanelli, Gianluca; Cristoferi, Massimo; Bottacchi, E.; Corso, Giovanni; Tosi, Piera; Sessa, Maria; Giossi, Alessia; Baietti,; Romano, G.; Meineri, P.; Armentano, A.; Versace, P.; Arcudi, L.; Galvano, Gianluca; Petralia, Benedetto; Feraco, P.; Luppi, G.; Giometto, Bruno; Bignamini, Valeria; Piffer, S.; Meloni, Giovanni Battista; Fabio, Claudio; Maiore, Mario; Pintus, Francesco; Pischedda, Aldo; Manca, Antonio; Mongili, Claudia; Zanda, Bastianina; Sanna, A.; Baule, Antonio; Florio, F; Ciccarese, G.; Leone, M.; Viesti, P. Di; Pappalardo, Maria Pia; Craparo, Giuseppe; Gallo, Cristina; Monaco, Serena; Mannino, Marina; Muto, Massimo; Guarnieri, GL.; Andreone, Vincenzo; Passalacqua, Giovanni; Allegritti, M.; Colosimo, Cesare; Caproni, S.; Filizzolo, M.; Salmaggi, Andrea; Giordano, Angela; Marini, C.; Sacco, Simona; Frattale, I.; Lucente, Giuseppe; Nozzoli, C.; Lupo, F. A.

doi:10.1007/s13760-022-02067-z

Cited by 8 publications

(2 citation statements)

References 17 publications

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“…In daily clinical practice, it is frequently associated with a diagnosis of carotid disease in patients undergoing cardiologic or peripheral artery evaluation and vice versa. Dual antiplatelet therapy initiated within 24 h of symptom onset (TIA and minor stroke) and, for select patients with disabling ischemic stroke, thrombolysis within 4 h with possible endovascular thrombectomy plus carotid stenting, can improve functional outcomes [4][5][6]. Postmortem studies demonstrated such findings with a high correlation in these different arterial districts [7,8].…”

Section: Introductionmentioning

confidence: 99%

Carotid Artery Disease in the Era of Biomarkers: A Pilot Study

et al. 2023

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The intima-media thickness (IMT) and its irregularities or ulcerations in the common carotid artery (CCA) are useful tools as sentinel biomarkers for the integrity of the cardiovascular system. Total homocysteine and lipoprotein levels are the most commonly used elements in cardiovascular risk stratification. Duplex ultrasound (DUS), associated with serum biomarkers, can be used simply to assess the degree of atherosclerotic disease and cardiovascular risk. This study highlights the role of different kinds of biomarkers, showing their usefulness and potentiality in multi-district atherosclerotic patients, especially for early diagnosis and therapy effectiveness monitoring. A retrospective analysis performed from September 2021 to August 2022, of patients with carotid artery disease, was performed. A total of 341 patients with a mean age of 53.8 years were included in the study. The outcomes showed an increased risk of stroke in patients with significative carotid artery disease, nonresponsive to therapy, monitored through a series of serum biomarkers (homocysteine, C-reactive protein, and oxidized LDL). In this reported experience, the systematic use of DUS in association with the multiple biomarkers approach was effective for the early identification of patients at higher risk of disease progression or inefficient therapy.

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Section: Introductionmentioning

confidence: 99%

Carotid Artery Disease in the Era of Biomarkers: A Pilot Study

et al. 2023

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“…One common challenge is that associated with intracranial vessel occlusion treatment combined with an ipsilateral carotid artery stenosis or occlusion, a so called “tandem lesion” (TL). Many investigators have shown the feasibility and safety of treatment of both lesions in one session with a superiority in terms of thrombolysis-in-cerebral-infarction-(TICI-) scale [ 1 ] and clinical outcome [ 2 ] as well as a similar rate of adverse events compared with staged treatment [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Triple platelet inhibition in intracranial thrombectomy with additional acute cervical stent angioplasty due to tandem lesion: a retrospective single-center analysis

Khanafer,

Henkes,

Bücke

et al. 2024

BMC Neurol

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Background Acute stroke treatment with intracranial thrombectomy and treatment of ipsilateral carotid artery stenosis/occlusion (“tandem lesion”, TL) in one session is considered safe. However, the risk of stent restenosis after TL treatment is high, and antiplatelet therapy (APT) preventing restenosis must be well balanced to avoid intracranial hemorrhage. We investigated the safety and 90-day outcome of patients receiving TL treatment under triple-APT, focused on stent-patency and possible disadvantageous comorbidities. Methods Patients receiving TL treatment in the setting of acute stroke between 2013 and 2022 were analyzed regarding peri-/postprocedural safety and stent patency after 90 days. All patients received intravenous eptifibatide and acetylsalicylic acid and one of the three drugs prasugrel, clopidogrel, or ticagrelor. Duplex imaging was performed 24 h after treatment, at discharge and 90 days, and digital subtraction angiography was performed if restenosis was suspected. Results 176 patients were included. Periprocedural complications occurred in 2.3% of the patients at no periprocedural death, and in-hospital death in 13.6%. Discharge mRS score was maintained or improved at the 90-day follow-up in 86%, 4.54% had an in-stent restenosis requiring treatment at 90 days. No recorded comorbidity considered disadvantageous for stent patency showed statistical significance, the duration of the endovascular procedure had no significant effect on outcome. Conclusion In our data, TL treatment with triple APT resulted in a low restenosis rate, low rates of sICH and a comparably high number of patients with favorable outcome. Aggressive APT in the initial phase may therefore have the potential to prevent recurrent stroke better than restrained platelet inhibition. Comorbidities did not influence stent patency.

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