Angioplasty alone versus acute stenting for acute tandem occlusions due to internal carotid artery atherosclerotic

Emergent carotid stenting versus no stenting for acute ischemic stroke due to tandem occlusion: a meta-analysis

“…Our search detected 1601 citations. Overall, 63 studies were potentially eligible for inclusion, and 46 reached qualitative synthesis11–18 23–60 (figure 1 for PRISMA flow-chart). Among them, 17 observational studies directly compared eCAS and no-stenting, while the remainder focused on a single approach (online supplemental table S1 for included study baseline features).…”

“…Intraprocedural antiplatelet protocols varied across studies: 15 studies used glycoprotein IIb/IIIa inhibitors (GPI)11 17 18 25 28–31 33 34 37 40 44 48 61 together with the dual antiplatelet therapy after 24 hours, while 13 studies used loading doses of single or dual antiplatelet drugs 4 13 15 23 26 32 36 38 41–43 50 51. Studies using rescue treatment with APTs or GPI after the standard protocol during eCAS were excluded from analysis owing to potential exposure bias 12 16 39 53 59 60. Pooling data from studies reporting sICH rate after intraprocedural use of antithrombotic agents during eCAS (n=20 studies), a marginal non-significant increase in sICH rate emerged in the GPI group compared with the APT group (11% vs 7%, p=0.08,online supplemental figure 10).…”

Antithrombotic regimen in emergent carotid stenting for acute ischemic stroke due to tandem occlusion: a meta-analysis of aggregate data

“…Overall, 71 observational studies were potentially eligible for inclusion, and 34 reached qualitative synthesis (figure 1 for PRISMA flow-chart, online supplemental table 2 for study details). Among them, two observational studies compared noAPT versus SAPT,18 19 three compared noAPT versus DAPT,18 20 21 two compared noAPT versus GPI,18 19 five compared SAPT versus DAPT,18 22–25 four compared SAPT versus GPI18 19 26 27 and four compared DAPT versus GPI,18 28–30 while the remainder focused on a single APT regimen 31–50…”

Endovascular Treatment of Tandem Atherosclerotic Cervical Internal Carotid Artery Occlusion in the Setting of Acute Ischemic Stroke

“…22,23 The PTA first strategy, which can be considered as a strategy that lies between the two aforementioned approaches, mitigates the advantages and disadvantages of both. 24,25 Therefore, we selected the PTA first approach as our first choice strategy in the middle of our series because we experienced critical complications with the CAS-first approach.…”