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Endovascular Therapy Strategy for Acute Embolic Tandem Occlusion: The Pass-Thrombectomy-Protective Thrombectomy

Wen-Huo Chen1, Ting-Yu Yi1, Yan-Min Wu1

  • 1Department of Neurology, Zhangzhou Affiliated Hospital of Fujian Medical University, Fujian, China.

World Neurosurgery
|August 28, 2018
PubMed

Insights

The pass-thrombectomy-protective thrombectomy (double PT) technique is a feasible and safe approach for treating tandem occlusions in acute ischemic stroke patients. This method showed successful recanalization and a good clinical outcome in a small patient cohort.

Area of Science:

  • Neurology
  • Interventional Neurology
  • Vascular Neurology

Background:

  • Embolic occlusions of the common carotid artery (CCA)/internal carotid artery (ICA) and intracranial arteries are common in acute ischemic stroke.
  • These occlusions lead to high morbidity and can be treated with endovascular therapy.
  • Optimal endovascular strategies for tandem occlusions remain unclear.

Purpose of the Study:

  • To evaluate the feasibility of the pass-thrombectomy-protective thrombectomy (double PT) technique.
  • To assess the clinical outcomes of patients treated with the double PT technique for tandem occlusions.

Main Methods:

  • Retrospective analysis of a prospective stroke registry database (January 2015 - February 2017).
  • Inclusion of 7 patients with tandem occlusions of the CCA/ICA and intracranial arteries.
  • Evaluation of clinical outcomes at 3 months using the modified Rankin Scale (mRS).

Main Results:

  • Successful recanalization was achieved in 85.7% of patients.
  • The median reperfusion time was 61 minutes.
  • A good clinical outcome (mRS ≤ 2) was observed in 42.9% of patients, with a 14.3% mortality rate.

Conclusions:

  • The double PT technique is a feasible and safe option for treating initial embolic tandem occlusions of the CCA/ICA.
  • Further research with larger cohorts is warranted to confirm these findings.
Abstract

Keywords:
Embolic eventEmbolic prevention deviceEndovascular therapyTandem occlusion

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