Endovascular treatment of acute tandem occlusion strokes and stenting first experience

Akpınar, Süha; Gelener, Pınar

doi:10.1016/j.jocn.2017.09.010

Cited by 10 publications

(2 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This might be the partially pathophysiologic explanation for favorable functional independence corresponding to successful reperfusion. Moreover, extracranial stent angioplasty prior to intracranial thrombectomy was hypothesized to increase additional procedure- and device-related complications due to scratching between thrombectomy device and carotid stent struts, especially in case of advancing resistance ( 33 , 34 ). Retrograde approach, through adopting the intracranial first strategy, could shun these potential risks associated with deteriorating clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Antegrade or Retrograde Approach for the Management of Tandem Occlusions in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis

Min

Bai

et al. 2022

Front. Neurol.

View full text Add to dashboard Cite

Background: Acute ischemic stroke (AIS) caused by tandem intracranial and extracranial occlusions is not rare. However, optimal strategy between antegrade (extracranial first) or retrograde (intracranial first) approaches still remains elusive. This systematic review and meta-analysis aim to compare the two approaches to provide updated clinical evidence of strategy selection.Methods: PubMed, Ovid, Web of Science, and the Cochrane Library were searched for literature comparing antegrade and retrograde approaches for patients with AIS with concomitant tandem occlusions. Outcomes including successful reperfusion [Throbolysis in Cerebral Infarction (TICI) 2b−3] and 90-day favorable outcome [modified Rankin Scale (mRS) 0–2], any intracerebral hemorrhage, symptomatic intracerebral hemorrhage, procedural complications, and mortality were evaluated. The risk of bias was assessed using the Newcastle–Ottawa Scale and illustrated in the Funnel plot. Heterogeneity was assessed by I2 statistic. Subgroup and sensitivity analyses were also performed.Results: A total of 11 studies accounting 1,517 patients were included. 831 (55%) patients were treated with an antegrade approach and 686 (45%) patients were treated with the retrograde approach. A higher successful reperfusion rate was achieved in retrograde group than that of antegrade group [83.8 vs. 78.0%; odds ratio (OR): 0.63, 95% CI: 0.40–0.99, p = 0.04]. 90-day favorable outcome (mRS 0–2 at 90 days) also showed significantly higher in retrograde group compared with antegrade group (47.3 vs. 40.2%; OR: 0.72, 95% CI: 0.58–0.89, p = 0.002). The incidence of any intracranial hemorrhage (ICH), symptomatic intracranial hemorrhage, 90-day mortality, and other complications did not differ between two groups.Conclusion: In AIS with tandem occlusions, the retrograde approach might achieve a higher successful reperfusion rate and better functional outcome with a comparable safety profile when compared with an antegrade approach. Further prospective controlled studies with more meticulous design and a higher level of evidence are needed to confirm these results.Systematic Review Registration: “PROSPERO” database (CRD 42020199093), https://www.crd.york.ac.uk/PROSPERO/.

show abstract

Section: Discussionmentioning

confidence: 99%

Antegrade or Retrograde Approach for the Management of Tandem Occlusions in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis

Min

Bai

et al. 2022

Front. Neurol.

View full text Add to dashboard Cite

show abstract

“…Diacinti et al described 4 rare cases with cerebral venous thrombosis, which lacks typical vascular signs and is difficult to be diagnosed early [10]. Akpinar et al reported 8 patients with acute tandem occlusion stroke and performed stentassisted thrombectomy to re-perfuse brain vessels [11]. Rosen et al investigated the cerebrovascular reactivity of 26 patients with intracranial steno-occlusive disease and evaluated the long-term beneficial effects of extracranial-intracranial bypass on cerebral blood-supply [12].…”

Section: Introductionmentioning

confidence: 99%

A Potentially Detrimental Pin1 in Cerebrovascular Pathology: Beyond its Traditionally Beneficial Regulation of Amyloid–β and Tau

Wang

Bai

et al. 2019

BJSTR

View full text Add to dashboard Cite

Cerebral vascular dysfunction causes various ischemic neurological disorders necessitating novel mechanism clarification. In this work, we presented the methods to identify nine single nucleotide polymorphism (SNP) sites of the Pin1 gene in Chinese patients suffered from cerebral infarction for the first time, suggesting that these SNPs have relatively high allele frequencies and may contribute to prevention of Pin1-related neurological diseases. Based on the preliminary interpretations, the SNPs rs2233678 (-842G) and rs2287839 (-5185C) may enhance Pin1 transcription and elicit impacts on thrombosis and atherosclerosis in brain vessels. We further firstly hypothesized a novel Pin1-eNOS-NO-cerebral vasodilatation signaling pathway, which may play a DETRIMENTAL role in cerebrovascular pathologies by blocking vascular diastole/ relaxation and leading to vascular thrombosis/occlusion in the brain. In summary, genetic polymorphisms of Pin1 may represent a new genetic basis for early diagnosis and precision medicine of cerebrovascular dysfunction, and predictably Pin1 inhibitors might have therapeutic efficacy for early prevention of cerebrovascular thrombosis and relevant neural disorders.

show abstract

Acute carotid stenting versus non-stenting treatment of acute ischemic stroke due to tandem lesions: a systematic review and meta-analysis

Wei,

Zhang,

Xie

et al. 2024

J Neurol

View full text Add to dashboard Cite

Endovascular treatment of acute tandem occlusion strokes and stenting first experience

Cited by 10 publications

References 15 publications

Antegrade or Retrograde Approach for the Management of Tandem Occlusions in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis

Antegrade or Retrograde Approach for the Management of Tandem Occlusions in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis

A Potentially Detrimental Pin1 in Cerebrovascular Pathology: Beyond its Traditionally Beneficial Regulation of Amyloid–β and Tau

Acute carotid stenting versus non-stenting treatment of acute ischemic stroke due to tandem lesions: a systematic review and meta-analysis

Contact Info

Product

Resources

About