TY - JOUR T1 - Endovascular treatment of acute tandem lesions in patients with mild anterior circulation stroke JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg DO - 10.1136/jnis-2022-019239 SP - neurintsurg-2022-019239 AU - Lukas Meyer AU - Maria Politi AU - Maria Alexandrou AU - Christian Roth AU - Andreas Kastrup AU - Anastasios Mpotsaris AU - Uta Hanning AU - Fabian Flottmann AU - Caspar Brekenfeld AU - Milani Deb-Chatterji AU - Goetz Thomalla AU - Helge Kniep AU - Tobias D Faizy AU - Matthias Bechstein AU - Gabriel Broocks AU - Moriz Herzberg AU - Katharina Feil AU - Lars Kellert AU - Franziska Dorn AU - Kamil Zeleňák AU - Jens Fiehler AU - Panagiotis Papanagiotou A2 - , Y1 - 2022/08/26 UR - http://jnis.bmj.com/content/early/2022/10/07/jnis-2022-019239.abstract N2 - Background In patients with mild strokes the risk–benefit ratio of endovascular treatment (EVT) for tandem lesions has yet to be evaluated outside of current guideline recommendations. This study investigates the frequency as well as procedural and safety outcomes in daily clinical practice.Methods Using data from the German Stroke Registry-Endovascular Treatment (GSR-ET) we analyzed patients with anterior circulation stroke due to tandem-lesions and mild deficits. These patients were defined as ≤5 on the National Institutes of Health Stroke Scale (NIHSS). Recanalization was assessed with the modified Thrombolysis in Cerebral Infarction Scale (mTICI). Early neurological and long-term functional outcomes were assessed with the NIHSS change and modified Rankin scale (mRS), respectively. Safety assessment included periprocedural complications and the rate of symptomatic intracerebral hemorrhage (sICH).Results A total of 61 patients met the inclusion criteria and were treated endovascularly for tandem lesions. The median age was 68 (IQR:59–76) and 32.9% (20) were female. Patients were admitted to the hospital with a median NIHSS score of 4 (IQR:2–5) and a median Alberta Stroke Programme Early CT Score (ASPECTS) of 9 (IQR:8–10). Successful recanalization (mTICI 2b-3) was observed in 86.9% (53). NIHSS decreased non-significantly (p=0.382) from baseline to two points (IQR:1–9) at discharge. Excellent (mRS≤1) and favorable (mRS≤2) long-term functional outcome at 90-days was 55.8% (29) and 69.2% (36), respectively. Mortality rates at 90-days were 9.6% (5) and sICH occurred in 8.2% (5).Conclusions EVT for tandem lesions in patients with mild anterior circulation stroke appears to be feasible but may lead to increased rates of sICH. Further studies comparing endovascular with best medical treatment (BMT) especially investigating the risk of periprocedural hemorrhagic complications, are needed.Data are available upon reasonable request. Data are available upon reasonable request and after approval of the GSR-ET Steering committee. ER -