Emergent XXXX stenting and mechanical thrombectomy in acute @entity64 .

@entity1 @entity64 @entity548 @entity3538 @entity432 @entity583 @entity385
OBJECTIVE: Tandem occlusions involving both the @entity3538 (ICA) and an intracranial artery typically respond poorly to intravenous (IV) tissue plasminogen activator (t-PA). We retrospectively review our experience with proximal ICA stenting and stent-assisted thrombectomy of the distal artery. METHODS: The data included @entity1 that underwent carotid stenting and mechanical thrombectomy between 2012-2013. Radiographic, clinical, and procedural data were drawn from case notes, imaging records and discharge reports. Clinical outcomes were evaluated using the National Institutes of Health @entity64 Scale (NIHSS) and the modified Rankin scale (mRs). RESULTS: Seven @entity1 , with a mean age of 66.4 years and a mean admission NIHSS of 18.3, underwent this procedure and were included. Each presented with an occlusion of the proximal ICA, with additional occlusions of the ICA terminus (n   =   3), middle cerebral artery (n   =   5), or anterior cerebral artery (n   =   1). Recanalisation of all identified occlusions was achieved in all @entity1 , with a Thrombolysis in @entity583 (TIMI) score of 3 and a Thrombolysis in @entity385 (TICI) score >2b achieved in each case. Mean time from onset of @entity64 symptoms to recanalisation was 287   min; mean time from first angiography to recanalisation was 52   min. Intracranial @entity548 occurred in two @entity1 , with no increase in NIHSS. There were no mortalities. Mean NIHSS at discharge was 4.9, and mRs at 90 days was one in all @entity1 . CONCLUSIONS: Treatment of tandem extracranial ICA and @entity432 in the setting of acute @entity64 with extracranial carotid artery stenting followed by adjunctive intracranial mechanical thrombectomy is both safe and effective, but further evaluation of this treatment modality is necessary.
