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Acute Ischemic Stroke due to Common Carotid Ostial Disease with Tandem Intracranial Occlusions Treated with Thrombectomy and Staged Retrograde Stenting.
| Content Provider | Europe PMC |
|---|---|
| Author | Amuluru, Krishna Al-Mufti, Fawaz Romero, Charles E. |
| Copyright Year | 2018 |
| Abstract | Background Acute ischemic stroke due to tandem occlusive lesions of the anterior circulation involves an intracranial large vessel occlusion as well as a concurrent occlusion or high-grade stenosis of the proximal carotid system. The vast majority of proximal lesions in tandem occlusive cases involve the extracranial internal carotid artery, although the lesion can theoretically exist anywhere along the carotid artery pathway, including the common carotid ostium. Summary To the best of our knowledge, only 1 report describes common carotid artery ostial lesions in the setting of acute ischemic stroke due to tandem occlusions, in which the authors describe an anterograde treatment paradigm. We present the first 2 cases of acute ischemic stroke secondary to common carotid ostial disease with tandem intracranial occlusion, treated with intracranial thrombectomy followed by subsequent staged balloon-mounted stenting of the common carotid ostium. We review the pathophysiology of tandem occlusions, the controversy surrounding treatment techniques, and various approaches used in the treatment of ostial occlusive lesions. Key Message In certain situations where acute carotid stenting is not safe or technically possible, immediate intracranial thrombectomy with a subsequent staged balloon-mounted stenting of the ostial lesion may be a reasonable and safe option. |
| Related Links | https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC6216780&blobtype=pdf |
| Page Count | 7 |
| ISSN | 16649737 |
| Volume Number | 7 |
| DOI | 10.1159/000490584 |
| PubMed Central reference number | PMC6216780 |
| Issue Number | 6 |
| PubMed reference number | 30410523 |
| Journal | Interventional Neurology [Interv Neurol] |
| e-ISSN | 16645545 |
| Language | English |
| Publisher | Karger Publishers |
| Publisher Date | 2018-07-13 |
| Publisher Place | Allschwilerstrasse 10, CH-4055 Basel, Switzerland |
| Access Restriction | Open |
| Rights License | Copyright © 2018 by S. Karger AG, Basel |
| Subject Keyword | Acute ischemic stroke Carotid artery stenosis Mechanical thrombectomy Stents Stent retriever Stroke Tandem |
| Content Type | Text |
| Resource Type | Article |
| Subject | Neurology (clinical) Surgery Cardiology and Cardiovascular Medicine |
