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Published on: January 18, 2018
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Rescue extracranial vertebral stenting in tandem occlusions: A preliminary Vietnamese study
Thang Le Minh1, Cuong Tran Chi1, Nam Nguyen Hoai2
1DSA Unit, Can Tho S.I.S General Hospital, Can Tho City, Vietnam.
Summary
Rescue extracranial vertebral stenting shows promise for acute posterior circulation tandem occlusions. This endovascular therapy improved outcomes in over half of patients, offering a viable alternative to mechanical thrombectomy.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Vascular Surgery
Background:
- Acute vertebrobasilar occlusion, especially tandem occlusions, carries a poor prognosis.
- Limited data exists on the effectiveness of endovascular therapy for these specific occlusions.
Purpose of the Study:
- To evaluate the efficacy of rescue extracranial vertebral stenting in improving clinical outcomes for acute posterior circulation tandem occlusions.
- To assess the modified Rankin Scale (mRS) score at 3 months post-procedure.
Main Methods:
- Retrospective analysis of patients with acute posterior tandem occlusion treated with rescue extracranial vertebral stenting.
- Data collection included clinical, neuroimaging, procedural details, and complications.
- Primary outcome was the rate of good outcomes (mRS ≤ 2) at 3-month follow-up.
Main Results:
- Nine patients with posterior circulation tandem occlusions underwent rescue extracranial vertebral stenting.
- Successful recanalization (mTICI ≥ 2b) was achieved in all patients.
- 55.6% of patients achieved a good outcome (mRS ≤ 2) at 3 months; one patient required decompressive craniectomy for malignant cerebellar infarction.
Conclusions:
- Rescue extracranial vertebral stenting can be a valuable treatment option for posterior tandem occlusions.
- This approach may serve as an important alternative following mechanical thrombectomy in selected cases.
