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Ismailova K.A.

Academician G.M. Savelyeva Municipal Clinical Hospital No. 31, Moscow, Russia;
Pirogov Russian National Research Medical University, Moscow, Russia

Laipanova L.R.

Academician G.M. Savelyeva Municipal Clinical Hospital No. 31, Moscow, Russia

Krasnikov A.P.

Academician G.M. Savelyeva Municipal Clinical Hospital No. 31, Moscow, Russia

Lukyanov A.L.

Academician G.M. Savelyeva Municipal Clinical Hospital No. 31, Moscow, Russia;
Pirogov Russian National Research Medical University, Moscow, Russia

Zlatovratsky A.G.

Academician G.M. Savelyeva Municipal Clinical Hospital No. 31, Moscow, Russia

Rogozin V.V.

Academician G.M. Savelyeva Municipal Clinical Hospital No. 31, Moscow, Russia

Khasanova L.T.

Academician G.M. Savelyeva Municipal Clinical Hospital No. 31, Moscow, Russia

Hybrid treatment for tandem occlusion of the internal carotid and middle cerebral arteries in ischemic stroke

Authors:

Ismailova K.A., Laipanova L.R., Krasnikov A.P., Lukyanov A.L., Zlatovratsky A.G., Rogozin V.V., Khasanova L.T.

More about the authors

Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2026;126(3‑2): 46‑51

DOI: 10.17116/jnevro202612603246

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Table of contents

HYBRID TREATMENT FOR TANDEM OCCLUSION OF THE INTERNAL CAROTID AND MIDDLE CEREBRAL ARTERIES IN ISCHEMIC STROKE
HYBRID TREATMENT FOR TANDEM OCCLUSION OF THE INTERNAL CAROTID AND MIDDLE CEREBRAL ARTERIES IN ISCHEMIC STROKE

To cite this article:

Ismailova KA, Laipanova LR, Krasnikov AP, Lukyanov AL, Zlatovratsky AG, Rogozin VV, Khasanova LT. Hybrid treatment for tandem occlusion of the internal carotid and middle cerebral arteries in ischemic stroke. S.S. Korsakov Journal of Neurology and Psychiatry. 2026;126(3‑2):46‑51. (In Russ.)
https://doi.org/10.17116/jnevro202612603246

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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Abstract:

The article presents a clinical case of hybrid treatment for tandem occlusion of the internal carotid artery (ICA) and the middle cerebral artery (MCA). The procedure was performed by a single surgical team in one operating room. First, an eversion carotid endarterectomy (ECEAE) for ICA was performed, followed by a common carotid artery (CCA) puncture and aspiration thrombectomy from MCA. The time from symptom onset to revascularization was 180 min. The outcome is favorable; the patient was discharged from the hospital with a neurological deficit of 2 points according to the National Institutes of Health Stroke Scale, 1 point on the modified Rankin Scale, and 13 points on the Rivermead Mobility Index. The paper presents a review of the literature on outcomes of surgical treatment for tandem occlusions in the ICA system.

Keywords:

internal carotid artery thrombosis
middle cerebral artery thrombosis
eversion carotid endarterectomy
mechanical thrombectomy
ischemic stroke
thrombolytic therapy
hybrid vascular intervention

Authors:

Ismailova K.A.

Academician G.M. Savelyeva Municipal Clinical Hospital No. 31, Moscow, Russia;
Pirogov Russian National Research Medical University, Moscow, Russia

Laipanova L.R.

Academician G.M. Savelyeva Municipal Clinical Hospital No. 31, Moscow, Russia

Krasnikov A.P.

Academician G.M. Savelyeva Municipal Clinical Hospital No. 31, Moscow, Russia

Lukyanov A.L.

Academician G.M. Savelyeva Municipal Clinical Hospital No. 31, Moscow, Russia;
Pirogov Russian National Research Medical University, Moscow, Russia

Zlatovratsky A.G.

Academician G.M. Savelyeva Municipal Clinical Hospital No. 31, Moscow, Russia

Rogozin V.V.

Academician G.M. Savelyeva Municipal Clinical Hospital No. 31, Moscow, Russia

Khasanova L.T.

Academician G.M. Savelyeva Municipal Clinical Hospital No. 31, Moscow, Russia

Received:

12.02.2026

Accepted:

25.02.2026

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References:

  1. Khripun AI, Mironkov AB, Likharev AYu, et al. Endovascular treatment of tandem acute occlusion of the internal carotid and middle cerebral arteries in acute ischemic stroke. S.S. Korsakov Journal of Neurology and Psychiatry. 2019;119(3-2):37-44.  https://doi.org/10.17116/jnevro201911903237
  2. Shcheglov DV, Zagorodniy VN, Konotopchyk SV, et al. Endovascular treatment of tandem occlusions in acute ischemic stroke. Ukrainska Interventsiina Neiroradiolohiia ta Khirurhiia (Ukrainian Interventional Neuroradiology and Surgery). 2021;2(36):73-81.  https://doi.org/10.26683/2786-4855-2021-2(36)-73-81
  3. Beneš V 3rd, Buchvald P, Klimošová S, Eichlová Z, Suchomel P. Acute extracranial occlusion of the internal carotid artery: emergent surgery remains a viable option. Acta Neurochir (Wien). 2014 May;156(5):901-908; discussion 908-909. Epub 2014 Mar 02. PMID: 24584902. https://doi.org/10.1007/s00701-014-2036-6
  4. Mbabuike N, Gassie K, Brown B, et al. Revascularization of tandem occlusions in acute ischemic stroke: review of the literature and illustrative case. Neurosurg Focus. 2017;42(4):15.  https://doi.org/10.3171/2017.1.FOCUS16521
  5. Cohen JE, Gomori M, Rajz G, et al. Emergent stent-assisted angioplasty of extrarcanial internal carotid artery and intracranial stent-based thrombectomy in acute tandem occlusive disease: technical consideration. J Neurointerv Surg. 2013;5:5:440-446.  https://doi.org/10.1136/neurintsurg-2012-010340
  6. Cobb MIH, Smith TP, Brown PA, et al. Carotid endarterectomy to remove retained Solitaire stent retriever inside carotid stent after mechanical thrombectomy. J Stroke Cerebrovasc Dis. 2017;26(5):90-95.  https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.02.015
  7. Frenkel MB, Renfrow JJ, Singh J, Garg N, Wolfe SQ. Combined interventional and surgical treatment of tandem middle cerebral artery embolus and internal carotid artery occlusion: case report. J Neurosurg. 2018 Sep; 129(3):718-722. Epub 2017 Nov 17. PMID: 29148900. https://doi.org/10.3171/2017.6.JNS162368
  8. Gunka I, Krajickova D, Lesko M, et al. Emergent carotid thromboendarterectomy for acute symptomatic occlusion of the extracranial internal carotid artery. Vasc Endovascular Surg. 2017;51(4):176-182.  https://doi.org/10.1177/1538574416674641
  9. Padalino DJ, Desaies EM. Tandem middle-cerebral artery-internal carotid artery occlusions: reduced occlusion-to-revascularization time using a transanterior communicating artery approach with a penumbra device. J Neurosurg. 2012;116:3:665-671.  https://doi.org/10.3171/2011.10.JNS111516
  10. Slawski DE, Jumaa MA, Salahuddin H, et al. Emergent carotid endarterectomy versus stenting in acute stroke patients with tandem occlusion. J Vasc Surg. 2018;68(4):1047-1053. https://doi.org/10.1016/j.jvs.2017.12.077
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