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Postulated advantages of each treatment approach for patients with tandem lesions (acute stent placement versus no acute stent placement)
Potential Advantages of Acute Stent PlacementPotential Advantages of No Acute Stent Placement
Treatment of the causative embolic lesion and lower risk of stroke recurrenceLower risk of intracranial hemorrhage (avoidance of hyperperfusion, acute antiplatelet agents)
Improvement of cerebral perfusion with potential attenuation of infarct progressionLower risk of iatrogenic artery-to-artery embolization during stent deployment
Contribution to spontaneous intracranial clot lysisNo risk of in-stent thrombosis
Avoids delays in intracranial recanalization (if stent placement before thrombectomy)
Lower risk of procedural bradycardia and hypotension from carotid baroreceptor activation with stent deployment