Journal article
Posterior circulation tandem occlusions: Classification and techniques
CLINICAL NEUROLOGY AND NEUROSURGERY, v 198, 106154
Nov 2020
PMID: 32829201
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Posterior circulation tandem occlusions are poorly characterized in current literature. Data regarding endovascular approaches and outcomes in this patient subgroup is extremely limited. Methods: We conducted a retrospective analysis of a prospectively maintained database and identified 17 patients with posterior circulation tandem occlusions who underwent mechanical thrombectomy between 2014 and 2019. Results: Of 17 patients with posterior circulation tandem occlusion, the mean age was 55.76 +/- 11.8 with 35.3% female. The mean NIHSS score on presentation was 17.2 +/- 9.2. Tissue plasminogen activator was administered in 7 (41.2%) patients, stent-retrievers alone were used in 2 (11.8%), aspiration catheters alone were used in 2 (11.8%), a combination was used 12 (70.6%), and a self-expandable stent in 5 (29.4%). The mean number of device passes was 2.24 +/- 2.02, recanalization failure occurred in 4 (23.5%) patients, the mean time from stroke onset to puncture was 6.9 +/- 2.4 h, and the mean time from puncture to recanalization was 59.3 +/- 26.6 min. Postprocedural symptomatic ICH occurred in 1 (5.9 %) patient, periprocedural ICH/SAH occurred in 2 (11.8%), periprocedural distal emboli occurred in 0 (0%), periprocedural vessel dissection occurred in 1 (5.9%), and periprocedural vessel perforation occurred in 1 (5.9%) patient. TICI score >= 2b was achieved in 13 (76.5%) patients. An improvement in NIHSS >= 3 at discharge occurred in 10 (58.8%) patients, and good outcomes (mRS score <= 2) occurred in 7 (41.2%). The mean length of stay was 11.6 +/- 12.2 days, and the mortality rate was 41.2%. Conclusion: Endovascular intervention with mechanical thrombectomy is safe and feasible in patients with posterior circulation tandem occlusions.
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Details
- Title
- Posterior circulation tandem occlusions: Classification and techniques
- Publication Details
- CLINICAL NEUROLOGY AND NEUROSURGERY, v 198, 106154
- Publisher
- ELSEVIER; AMSTERDAM
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:000587346400038
- Scopus ID
- 2-s2.0-85089518157
- Other Identifier
- 991021860771304721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery