Title:Effects of Different Etiologies of Anterior Circulation Tandem Lesions on
Short-term Prognosis of Acute Ischemic Stroke
Volume: 20
Issue: 1
Author(s): Zhichao Huang, Yingying Xu, Shoujiang You, Zhiliang Guo, Jiaping Xu, Yongjun Cao, Guodong Xiao*Chun-Feng Liu*
Affiliation:
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital
of Soochow University, Suzhou, China
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital
of Soochow University, Suzhou, China
Keywords:
Tandem lesion, carotid artery dissection, atherosclerosis, thrombectomy, prognosis, EVT, LAA.
Abstract:
Introduction: The prognosis of anterior circulation tandem lesions caused by carotid artery
dissection (CAD) and large artery atherosclerosis (LAA) after mechanical thrombectomy is controversial.
By analyzing the clinical data of different etiologies, we explored the best treatment plan.
Methods: Clinical data of patients with anterior circulation tandem lesions admitted to the Second
Affiliated Hospital of Soochow University from April 2018 to October 2021 were retrospectively
collected. The Modified Rankin Scale was used as the standard to evaluate the functional prognosis
of patients at 3 months. Safety assessment included symptomatic intracranial hemorrhage (sICH)
and mortality. The technical evaluation of interventional procedures included operation time, successful
recanalization, and times of pass.
Results: 74 patients were enrolled, 59 in the LAA group and 15 in the CAD group. The two groups
were similar regarding the proportion of successful recanalization, the bridge treatment and the
choice of surgical instruments. The puncture to recanalization time and the onset of symptoms to
successful recanalization time had no significant difference (p > 0.05). There were no significant
differences in hemorrhage transformation (p = 0.26), sICH (p > 0.999), good functional prognosis
(p = 0.054), and mortality (p = 0.181) between the two groups. We found a trend toward a better
functional outcome at 3 months in the CAD group (p = 0.054).
Conclusion: The tandem lesions of anterior circulation caused by CAD tend to have a good functional
prognosis in 3 months. The proportion of successful recanalization and surgical safety was
similar between the two groups.
