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RT Journal Article
SR Electronic
T1 Tandem Carotid Lesions in Acute Ischemic Stroke: Mechanisms, Therapeutic Challenges, and Future Directions
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1142
OP 1148
DO 10.3174/ajnr.A6582
VO 41
IS 7
A1 Poppe, A.Y.
A1 Jacquin, G.
A1 Roy, D.
A1 Stapf, C.
A1 Derex, L.
YR 2020
UL http://www.ajnr.org/content/41/7/1142.abstract
AB SUMMARY: Approximately 15% of patients undergoing endovascular thrombectomy for anterior circulation acute ischemic stroke have a tandem lesion, defined as a severe stenosis or occlusion of the cervical internal carotid artery ipsilateral to its intracranial occlusion. Patients with tandem lesions have worse outcomes than patients with isolated intracranial occlusions, but the optimal management of their carotid lesions during endovascular thrombectomy remains controversial. The main options commonly used in current practice include acute stent placement in the carotid lesion versus thrombectomy alone without definitive revascularization of the carotid artery. While treatment decisions for these patients are often complex and strategies vary according to clinical, anatomic, and technical considerations, only results from randomized trials comparing these approaches are likely to strengthen current recommendations and optimize patient care.AISacute ischemic strokec-ICAcervical internal carotid arteryEVTendovascular thrombectomyIVTintravenous thrombolysisTLtandem lesion