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. 2023 Mar 11;9(3):e14508.
doi: 10.1016/j.heliyon.2023.e14508. eCollection 2023 Mar.

Outcome and risk of hemorrhage in patients with tandem lesions after endovascular treatment: A propensity score-matched case-control study

Dominik Sepp  1 , Maria Berndt  1 , Sebastian Mönch  1 , Benno Ikenberg  2 , Silke Wunderlich  2 , Christian Maegerlein  1 , Claus Zimmer  1 , Tobias Boeckh-Behrens  1 , Benjamin Friedrich  1
Affiliations

Outcome and risk of hemorrhage in patients with tandem lesions after endovascular treatment: A propensity score-matched case-control study

Dominik Sepp et al. Heliyon. .

Erratum in

Abstract

Objectives: Endovascular treatment of acute stroke patients with large vessel occlusions is well established. But tandem lesions of the internal carotid artery and the intracranial anterior circulation remain a challenge regarding the technical conditions and the putative higher risk of hemorrhage due to often required antiplatelet therapy.This study aims to evaluate the clinical outcome and the risk of hemorrhage after endovascular treatment of tandem lesions, with special regard to the periprocedural antiplatelet regimen.

Materials and methods: In this retrospective study, we included 63 consecutive stroke patients with endovascular treated tandem lesions. One hundred eleven patients with a solitary intracranial occlusion were matched using a "propensity score-matched analysis" with the covariates sex, age, wake-up stroke, iv-thrombolysis and NIHSS.

Results: Rates of successful recanalization (mTICI 2b/3) and periprocedural complications were equal in both groups (P = 0.19; P = 0.35). The rate of good clinical outcome (mRS≤2) was similar, and the incidence of symptomatic hemorrhages was not significantly different (7.9% tandem lesions vs. 5.4% isolated intracranial occlusion, P = 0.51). Even intensified antiplatelet therapy in patients with tandem lesions did not increase the rate of symptomatic intracranial hemorrhages (P = 0.87).

Conclusions: Clinical outcome and symptomatic intracranial hemorrhages did not differ significantly between endovascular treated patients with tandem lesions and matched patients with solitary intracranial occlusions, regardless of the antiplatelet regimen. Therefore, the complex technical requirements for recanalization of a tandem lesion and the putative higher risk should not result in reluctant treatment that would decrease the chance of a good clinical outcome.

Keywords: Antiplatelet agents; Stenting; Stroke; Tandem occlusion; Thrombectomy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Distribution of modified Ranking Scale (mRS) at discharge in patients with tandem lesions and patients with isolated intracranial occlusion.
Fig. 2
Fig. 2
Distribution of modified Ranking Scale (mRS) after 90 days in patients with tandem lesions and patients with isolated intracranial occlusion.
Fig. 3
Fig. 3
Distribution of modified Ranking Scale (mRS) at discharge in patients with tandem lesions categorized by the antiplatelet regimen.
Fig. 4
Fig. 4
Distribution of modified Ranking Scale (mRS) after 90 days in patients with tandem lesions categorized by the antiplatelet regimen.
See this image and copyright information in PMC

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