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

Autor:	Khripun AI; Pirogov Russian National Research Medical University, Moscow, Russia., Salikov AV; Buyanov City Clinical Hospital, Moscow, Russia., Mironkov AB; Pirogov Russian National Research Medical University, Moscow, Russia.; Buyanov City Clinical Hospital, Moscow, Russia., Pryamikov AD; Pirogov Russian National Research Medical University, Moscow, Russia.; Buyanov City Clinical Hospital, Moscow, Russia., Asratyan SA; Buyanov City Clinical Hospital, Moscow, Russia., Suryakhin VS; Buyanov City Clinical Hospital, Moscow, Russia., Kamchatnov PR; Pirogov Russian National Research Medical University, Moscow, Russia., Sazhina OA; Buyanov City Clinical Hospital, Moscow, Russia., Zakharov KA; Buyanov City Clinical Hospital, Moscow, Russia.
Jazyk:	ruština
Zdroj:	Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova [Zh Nevrol Psikhiatr Im S S Korsakova] 2020; Vol. 120 (12. Vyp. 2), pp. 5-10.
DOI:	10.17116/jnevro20201201225
Abstrakt:	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.
Databáze:	MEDLINE
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