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. 2025 Mar 1;28(2):234-240.
doi: 10.4103/aian.aian_828_24. Epub 2025 Apr 10.

Stenting Versus Non-stenting Strategy in Endovascular Treatment of Acute Anterior Ischemic Stroke Patients with Tandem Occlusion

Hüseyin Nezih Özdemir  1 , Birgül Dere  1 , Ayşe Güler  1 , Celal Çınar  2 , Hadiye Şirin  1 , Bedriye Karaman  1 , Emre Kumral  1
Affiliations

Stenting Versus Non-stenting Strategy in Endovascular Treatment of Acute Anterior Ischemic Stroke Patients with Tandem Occlusion

Hüseyin Nezih Özdemir et al. Ann Indian Acad Neurol. .

Abstract

Background and objectives: The optimal endovascular treatment (EVT) strategy for acute tandem occlusion patients has not been decided yet, and a knowledge gap still exists in the literature. Therefore, we aimed to compare the two different interventional strategies, stenting and non-stenting, for the treatment of acute tandem occlusion patients.

Methods: This was a single-center, retrospective, observational cohort study, which was conducted in a tertiary referral center. We reviewed all acute stroke patients between January 2016 and January 2024. We assessed the effects of the two strategies, stenting and non-stenting, on seven outcome measures, namely: hemorrhagic transformation after EVT, number of days in the neurology intensive care unit (N-ICU), number of days in the hospital, in-hospital mortality, functional outcome at discharge, 3-month functional outcome, and 3-month mortality.

Results: We included 54 acute tandem occlusion patients who were treated with EVT in the study. Thirty-five (64.8%) patients underwent emergency carotid stenting during EVT and 19 patients (35.2%) did not receive emergency carotid stenting. Hemorrhagic transformation after EVT, number of days in N-ICU, number of days in the hospital, in-hospital mortality, functional outcome at discharge, and 3-month functional outcome did not differ between the two groups ( P > 0.05). Emergency stenting during EVT significantly reduced the probability of 3-month mortality (odds ratio = 0.21, confidence interval: 0.04 to 0.96, P = 0.04).

Conclusions: This study showed that emergency stenting in the acute tandem occlusion patients decreased the probability of mortality. Further research is needed on this.

Keywords: Stroke; carotid artery diseases; endovascular therapy; stents.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Stacked bar graphics showing mRS at discharge and 3-month mRS. The numbers in the graphics indicate the number of patients for the given mRS. mRS: modified Rankin Scale
See this image and copyright information in PMC

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