Acute Stroke and Obstruction of the Extracranial Carotid Artery Combined with Intracranial Tandem Occlusion: Results of Interventional Revascularization

Lescher, Stephanie; Czeppan, Katja; Porto, Luciana; Singer, Oliver C.; Berkefeld, Joachim

doi:10.1007/s00270-014-1047-2

Cited by 54 publications

(55 citation statements)

References 33 publications

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“…Nowadays, in most centres, i.v aspirin is advised promptly and double antiplatelet treatment on the following days in patient wall stents is applied. 8,9 Atrial fibrillation The most frequent reason resulting in an ICA pseudo-occlusion appearance in our study group was AF, which was observed in five patients. We realized that different locations of occlusion may give rise to the pseudo-occlusion appearance in the AF group.…”

Section: Ethical Approvalmentioning

confidence: 79%

“…aspirin for the initial treatment followed by a double antiplatelet regime. 8,9 In all these applications, although haemorrhage is the most feared outcome, acute thrombosis of the stent could occur. Acute thrombosis of stents, generating a high-grade stenosis, can give rise to tandem occlusions and present as a CT pseudo-occlusion.…”

Section: Cervical Internal Carotid Artery Dissectionmentioning

confidence: 99%

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Aetiologies of internal carotid artery pseudo-occlusions in acute stroke patients: what neurointerventionalists can expect

Akpınar¹,

Gelener²,

Yılmaz³

2017

The British Journal of Radiology

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In cases of acute stroke, differentiation between an occluded and a patent internal carotid artery (ICA) is crucial for diagnosis and management. Although CT angiography (CTA) can be highly accurate in defining high-grade stenosis and ICA occlusions, misleading ICA occlusion patterns are not rare in patients with acute stroke. We investigated the underlying causes of ICA pseudo-occlusions with CTA with respect to digital subtraction angiography. 11 out of 72 patients had pseudo-occlusion on CTA. Of these, there were three cases of tandem occlusions accompanying highgrade ICA stenosis, five cases of Distal ICA bifurcation occlusion as a result of atrial fibrillation, two cases of cervical ICA dissection and one acute thrombosis of the stent. Consideration of the aforementioned aetiologies by interventionists is warranted, as it may change the planning of endovascular intervention and treatment of acute stroke.

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Section: Ethical Approvalmentioning

confidence: 79%

Section: Cervical Internal Carotid Artery Dissectionmentioning

confidence: 99%

Aetiologies of internal carotid artery pseudo-occlusions in acute stroke patients: what neurointerventionalists can expect

Akpınar¹,

Gelener²,

Yılmaz³

2017

The British Journal of Radiology

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“…28 Recently published cohort studies indicate that tandem stenosis/occlusions of the ICA/MCA can be treated with acute stenting of the extracranial internal carotid and stent retriever mechanical thrombectomy in the MCA with a reasonable risk profile. [29][30][31][32][33] However, further evaluation of this treatment strategy is warranted.…”

Section: Aspects To Be Considered In Mechanical Thrombectomymentioning

confidence: 99%

Mechanical thrombectomy in acute ischemic stroke: Consensus statement by ESO-Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN

Wahlgren

Moreira

Michel³

et al. 2015

International Journal of Stroke

327

227

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The original version of this consensus statement on mechanical thrombectomy was approved at the European Stroke Organisation (ESO)-Karolinska Stroke Update conference in Stockholm, 16-18 November 2014. The statement has later, during 2015, been updated with new clinical trials data in accordance with a decision made at the conference. Revisions have been made at a face-to-face meeting during the ESO Winter School in Berne in February, through email exchanges and the final version has then been approved by each society. The recommendations are identical to the original version with evidence level upgraded by 20 February 2015 and confirmed by 15 May 2015. The purpose of the ESO-Karolinska Stroke Update meetings is to provide updates on recent stroke therapy research and to discuss how the results may be implemented into clinical routine. Selected topics are discussed at consensus sessions, for which a consensus statement is prepared and discussed by the participants at the meeting. The statements are advisory to the ESO guidelines committee. This consensus statement includes recommendations on mechanical thrombectomy after

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“…Others are caused by extracranial occlusions. Second, the underlying etiologies of ICA occlusion are too complicated to make an accurate judgment of the lesion pattern such as atherosclerosis, thromboembolic or artery dissection [34]. Third, the original size of the clots is usually larger in ICA than that of those ending up in the MCA.…”

Section: Possible Factors Influencing the Outcomes Of Stroke From Carmentioning

confidence: 99%

Treatment Strategies for Acute Ischemic Stroke Caused by Carotid Artery Occlusion

Yin

et al. 2016

Intervent Neurol

1,736

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Background: Acute ischemic stroke caused by internal carotid artery (ICA) occlusion usually has a poor prognosis, especially the T occlusion cases without functional collaterals. The efficacy of intravenous (IV) or intra-arterial (IA) thrombolysis with recombinant tissue plasminogen activator (rt-PA) remains ambiguous in these patients. Eendovascular recanalization of the occluded carotid has been attempted in recent years as a potential strategy. However, the different etiologies of ICA occlusion pose a significant challenge to neurointerventionists. Recently, several endovascular evolvements have been reported in treating carotid occlusion-related stroke. This review summarizes the current status of treatment for acute ICA occlusion.

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Acute Stroke and Obstruction of the Extracranial Carotid Artery Combined with Intracranial Tandem Occlusion: Results of Interventional Revascularization

Cited by 54 publications

References 33 publications

Aetiologies of internal carotid artery pseudo-occlusions in acute stroke patients: what neurointerventionalists can expect

Aetiologies of internal carotid artery pseudo-occlusions in acute stroke patients: what neurointerventionalists can expect

Mechanical thrombectomy in acute ischemic stroke: Consensus statement by ESO-Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN

Treatment Strategies for Acute Ischemic Stroke Caused by Carotid Artery Occlusion

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