RT Journal Article
SR Electronic
T1 Tandem stents thrombectomy as a rescue treatment for refractory large vessel occlusions
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 33
OP 38
DO 10.1136/neurintsurg-2020-015822
VO 13
IS 1
A1 Haowen Xu
A1 Shanling Peng
A1 Tao Quan
A1 Yongjie Yuan
A1 Zibo Wang
A1 Xiaojie Fu
A1 Kaihao Han
A1 Guo Liu
A1 Sheng Guan
A1 Panxing Li
YR 2021
UL http://jnis.bmj.com/content/13/1/33.abstract
AB Background Mechanical thrombectomy with a stent retriever (SR) and/or aspiration is the 'gold standard' for the treatment of acute ischemic stroke due to large vessel occlusion (LVO). However, sometimes clots may not be retrievable with a single SR alone or combined with aspiration.Objective To assess the safety and efficacy of a novel tandem stents thrombectomy (TST) technique as a rescue treatment for acute LVO that is refractory to conventional attempts.Methods All patients treated with the TST technique as rescue treatment after failure of conventional attempts were retrospectively reviewed. The postprocedural angiographic and clinical outcome, including modified Thrombolysis in Cerebral infarction (mTICI) grade, National Institutes of Health Stroke Scale (NIHSS) score, and modified Rankin Scale (mRS) score, was assessed.Results Nine patients (mean age, 65.2 years; median NIHSS score 18) with middle cerebral artery M1 segment (n=6) and terminal internal carotid artery (n=3) occlusions were included in the study. The TST technique was performed as a rescue treatment after unsuccessful stent thrombectomy alone (four cases) and stent thrombectomy plus aspiration (five cases). Successful recanalization (mTICI 2b/3) was achieved in all patients. No procedure-related complications occurred except reversible vasospasms were observed in three patients and one patient developed hemorrhage transformation after the procedure, but was asymptomatic. Three patients had good clinical outcome (mRS score 0–2 at 90 days). Two patients (22.2%) died.Conclusions The TST technique seems to be a safe and effective rescue treatment for acute LVO that is refractory to conventional attempts.