TY - JOUR T1 - Tandem stents thrombectomy as a rescue treatment for refractory large vessel occlusions JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg SP - 33 LP - 38 DO - 10.1136/neurintsurg-2020-015822 VL - 13 IS - 1 AU - Haowen Xu AU - Shanling Peng AU - Tao Quan AU - Yongjie Yuan AU - Zibo Wang AU - Xiaojie Fu AU - Kaihao Han AU - Guo Liu AU - Sheng Guan AU - Panxing Li Y1 - 2021/01/01 UR - http://jnis.bmj.com/content/13/1/33.abstract N2 - 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. ER -