계명대학교 의학도서관 Repository

Carotid Artery Stenting and Intracranial Thrombectomy for Tandem Cervical and Intracranial Artery Occlusions

Metadata Downloads
Author(s)
Byungjun KimByung Moon KimOh Young BangJang-Hyun BaekJi Hoe HeoHyo Suk NamYoung Dae KimJoonsang YooDong Joon KimPyoung JeonSeung Kug BaikSang Hyun SuhKyung-Yul LeeHyo Sung KwakHong Gee RohYoung-Jun LeeSang Heum KimChangWoo RyuYon-Kwon IhnHong-Jun JeonJinWoo KimJun Soo ByunSangil SuhJeong Jin ParkWoong Jae LeeJieun RohByoung-soo Shin
Keimyung Author(s)
Yoo, Joon Sang
Department
Dept. of Neurology (신경과학)
Journal Title
Neurosurgery
Issued Date
2019
Keyword
Acute strokeCarotid arteriesStentThrombectomy
Abstract
BACKGROUND:
It remains controversial whether carotid artery stenting (CAS) is needed in cases of tandem cervical internal carotid artery occlusion (cICAO) and intracranial large vessel occlusion (LVO).

OBJECTIVE:
To investigate the efficacy and safety of CAS in combination with endovascular thrombectomy (CAS-EVT) in cICAO-LVO patients and to compare its outcomes with those of EVT without CAS (EVT-alone).

METHODS:
We identified all patients who underwent EVT for tandem cICAO-LVO from the prospectively maintained registries of 17 stroke centers. Patients were classified into 2 groups: CAS-EVT and EVT-alone. Clinical characteristics and procedural and clinical outcomes were compared between 2 groups. We tested whether CAS-EVT strategy was independently associated with recanalization success.

RESULTS:
Of the 955 patients who underwent EVT, 75 patients (7.9%) had cICAO-LVO. Fiftysix patients underwent CAS-EVT (74.6%), and the remaining 19 patients underwent EVTalone (25.4%). The recanalization (94.6% vs 63.2%, P=.002) and good outcome rates (64.3% vs 26.3%, P=.007)were significantly higher in the CAS-EVT than in the EVT-alone.Mortality was significantly lower in the CAS-EVT (7.1% vs 21.6%, P = .014). There was no significant difference in the rate of symptomatic intracranial hemorrhage between 2 groups (10.7 vs 15.8%; P = .684) and according to the use of glycoprotein IIb/IIIa inhibitor (10.0% vs 12.3%; P=.999) or antiplatelet medications (10.2% vs 18.8%; P=.392). CAS-EVT strategy remained independently associated with recanalization success (odds ratio: 24.844; 95% confidence interval: 1.445-427.187).

CONCLUSION:
CAS-EVT strategy seemed to be effective and safe in cases of tandem cICAO-LVO. CAS-EVT strategy was associated with recanalization success, resulting in better clinical outcome.
Keimyung Author(s)(Kor)
유준상
Publisher
School of Medicine (의과대학)
Citation
Byungjun Kim et al. (2019). Carotid Artery Stenting and Intracranial Thrombectomy for Tandem Cervical and Intracranial Artery Occlusions. Neurosurgery. doi: 10.1093/neuros/nyz026
Type
Article
ISSN
1524-4040
Source
https://academic.oup.com/neurosurgery/advance-article/doi/10.1093/neuros/nyz026/5372261
DOI
10.1093/neuros/nyz026
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41953
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
공개 및 라이선스
  • 공개 구분공개
  • 엠바고Forever
파일 목록

Items in Repository are protected by copyright, with all rights reserved, unless otherwise indicated.