Results of endovascular treatment of acute tandem occlusion of internal carotid and middle cerebral arteries

Khripun A.I.; Salikov A.V.; Mironkov A.B.; Pryamikov A.D.; Asratyan S.A.; Suryakhin V.S.; Kamchatnov P.R.; Sazhina O.A.; Zakharov K.A.

doi:https://doi.org/10.17116/jnevro20201201225

Khripun A.I.

Pirogov Russian National Research Medical University

ORCID: 0000-0001-7669-0835

Salikov A.V.

Buyanov City Clinical Hospital

Mironkov A.B.

Pirogov Russian National Research Medical University;
Buyanov Moscow City Clinical Hospital

ORCID: 0000-0003-0951-908X

Pryamikov A.D.

Pirogov Russian National Research Medical University;
Buyanov Moscow City Clinical Hospital

ORCID: 0000-0002-4202-7549

Asratyan S.A.

Buyanov City Clinical Hospital

Suryakhin V.S.

Buyanov City Clinical Hospital

Kamchatnov P.R.

Pirogov Russian National Research Medical University

SPIN RSCI: 9240-6754
Scopus AuthorID: 6602401209
ORCID: 0000-0001-6747-3476

Sazhina O.A.

Buyanov City Clinical Hospital

Zakharov K.A.

Eco-Safety Research Center LLC

ORCID: 0000-0002-0557-0382

Results of endovascular treatment of acute tandem occlusion of internal carotid and middle cerebral arteries

Authors:

Khripun A.I., Salikov A.V., Mironkov A.B., Pryamikov A.D., Asratyan S.A., Suryakhin V.S., Kamchatnov P.R., Sazhina O.A., Zakharov K.A.

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Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(12‑2): 5‑10

DOI: 10.17116/jnevro20201201225

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To cite this article:

Khripun AI, Salikov AV, Mironkov AB, et al. Results of endovascular treatment of acute tandem occlusion of internal carotid and middle cerebral arteries. S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(12‑2):5‑10. (In Russ.)
https://doi.org/10.17116/jnevro20201201225

Подписка 2026 Журнал неврологии и психиатрии им. С.С. Корсакова. Спецвыпуски (S.S. Korsakov Journal of Neurology and Psychiatry (special issues))

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OBJECTIVE

To evaluate the results of endovascular treatment of patients with ischemic stroke caused by acute tandem occlusion of the internal carotid and middle cerebral arteries (ICA and MCA).

MATERIAL AND METHODS

Endovascular intervention was performed in 8 patients with tandem occlusion of ICA and MCA. The neurological deficit on admission was 17.4±5.6 NIHSS points and the average ASPECTS score was 9.5±0.8. The time from the onset of neurological symptoms to reperfusion was 224±68 min. Thrombolytic therapy was initiated before brain revascularization and continued intraoperatively in 4 out of 8 patients. ICA stenting after aspiration thrombectomy was required in 6 patients. Both antegrade (n=4) and retrograde (n=2) methods of brain revascularization were used.

RESULTS

The rate of detection of tandem lesion in patients with ischemic stroke who underwent endovascular treatment was 5.4%. Technical success in restoring blood flow in the ICA basin at extra-and intra-cranial levels (mTICI 2b/3) was achieved in 7 (87.5%) patients. Intracranial hemorrhagic complications that affected the outcome of the disease were clinically significant in 25% of patients (n=2). The mortality rate was 37.5% (n=3). A satisfactory clinical result (a deficit of 0—2 mRS scores) was achieved at discharge in one of 5 surviving patients.

CONCLUSION

Further studies of choosing the optimal surgical tactics for tandem occlusion of ICA and MCA, taking into account its effectiveness and safety, are need.

Keywords:

ischemic stroke

tandem occlusion

carotid artery occlusion

middle cerebral artery occlusion

endovascular treatment

Authors:

Khripun A.I.

Pirogov Russian National Research Medical University

ORCID: 0000-0001-7669-0835

Salikov A.V.

Buyanov City Clinical Hospital

Mironkov A.B.

Pirogov Russian National Research Medical University;
Buyanov Moscow City Clinical Hospital

ORCID: 0000-0003-0951-908X

Pryamikov A.D.

Pirogov Russian National Research Medical University;
Buyanov Moscow City Clinical Hospital

ORCID: 0000-0002-4202-7549

Asratyan S.A.

Buyanov City Clinical Hospital

Suryakhin V.S.

Buyanov City Clinical Hospital

Kamchatnov P.R.

Pirogov Russian National Research Medical University

SPIN RSCI: 9240-6754
Scopus AuthorID: 6602401209
ORCID: 0000-0001-6747-3476

Sazhina O.A.

Buyanov City Clinical Hospital

Zakharov K.A.

Eco-Safety Research Center LLC

ORCID: 0000-0002-0557-0382

Received:

08.09.2020

Accepted:

26.10.2020

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References:

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