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01-01-2017 | Neuro

Stent-Retriever Thrombectomy for Acute Anterior Ischemic Stroke with Tandem Occlusion: A Systematic Review and Meta-Analysis

Authors: Rotem Sivan-Hoffmann, Benjamin Gory, Xavier Armoiry, Mayank Goyal, Roberto Riva, Paul Emile Labeyrie, Anne-Claire Lukaszewicz, Jean-Jacques Lehot, Laurent Derex, Francis Turjman

Published in: European Radiology | Issue 1/2017

Abstract

Objectives

To assess the efficacy and safety profile of stent-retriever thrombectomy (SRT) in acute anterior ischemic stroke patients with tandem occlusion.

Materials and methods

Using the MEDLINE database, we conducted a systematic review and meta-analysis of all studies that included patients with acute ischemic stroke attributable to tandem occlusion who received treatment with SRT between November 2010 and May 2015.

Results

The literature search identified 11 previous studies involving a total of 237 subjects out of whom 193 (81.4 %) were treated with acute stent placement for the extracranial internal carotid artery occlusion. Mean initial NIHSS score was 17, and median time from onset to recanalization was 283.5 min. Mean intravenous thrombolysis rate was 63.8 %. In the meta-analysis, the recanalization rate reached 81 % (95 % CI, 73–89). Meta-analysis of clinical outcomes showed a pooled estimate of 44 % (95 % CI, 33–55; 10 studies) for favourable outcome, 13 % (95 % CI, 8–20; 10 studies) for mortality, and 7 % (95 % CI, 2–13; eight studies) for symptomatic intracranial haemorrhage.

Conclusion

SRT with emergency carotid stenting is associated with acceptable safety and efficacy in acute anterior stroke patients with tandem occlusion compared to natural history. However, the best modality to treat proximal stenosis is based on an individual case basis.

Key Points

• Stent retriever thrombectomy of tandem occlusion is efficient and safe.

• Emergent carotid stenting during thrombectomy increase symptomatic intracranial haemorrhage without impact mortality.

• Thrombectomy of tandem anterior circulation occlusion may be the first therapeutic option

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Title: Stent-Retriever Thrombectomy for Acute Anterior Ischemic Stroke with Tandem Occlusion: A Systematic Review and Meta-Analysis
Authors: Rotem Sivan-Hoffmann
Benjamin Gory
Xavier Armoiry
Mayank Goyal
Roberto Riva
Paul Emile Labeyrie
Anne-Claire Lukaszewicz
Jean-Jacques Lehot
Laurent Derex
Francis Turjman
Publication date: 01-01-2017
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 1/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4338-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Stent-Retriever Thrombectomy for Acute Anterior Ischemic Stroke with Tandem Occlusion: A Systematic Review and Meta-Analysis

Abstract

Objectives

Materials and methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusion

Key Points

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