Abstract
Objectives
The optimal endovascular treatment for tandem occlusion in anterior circulation ischaemic
stroke remains unknown. The aim of this study was to examine how the aetiology of
carotid pathology, dissection versus atherothrombosis, affects clinical outcomes.
Materials and Methods
Data was obtained from prospectively collected registries from two stroke centres
between April 2016 and December 2020. Tandem cases with complete cervical internal
carotid artery (ICA) occlusion or near-total occlusion (≥90% stenosis) were included.
Patients were divided into two groups based on carotid pathology: dissection versus
atherothrombosis.
Results
A total of 134 patients were included: 36 were dissection and 98 were atherothrombosis.
The dissection group had better clinical outcomes compared to the atherothrombosis
group, although after adjusting for age and stroke risk factors differences were non-significant.
In the non-stented cohort, the dissection patients achieved a better outcome (modified
Rankin scale 0-2) than atherothrombotic patients (57% vs. 34%, p=0.04) at 90-days.
Conclusion
Dissection-related tandem occlusions appear to have different clinical features from
atherothrombotic tandem occlusions which suggests different management strategies
are needed.
Keywords
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Article info
Publication history
Published online: December 03, 2022
Accepted:
November 22,
2022
Received in revised form:
November 10,
2022
Received:
August 5,
2022
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106910
Copyright
© 2022 Elsevier Inc. All rights reserved.
