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Endovascular Recanalization of Tandem Internal Carotid Occlusions Using the Balloon-assisted Tracking Technique.
- Source :
-
Clinical neuroradiology [Clin Neuroradiol] 2022 Jun; Vol. 32 (2), pp. 375-384. Date of Electronic Publication: 2021 Sep 21. - Publication Year :
- 2022
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Abstract
- Purpose: Tandem occlusive lesions are responsible for up to 20% of acute ischemic stroke cases and are associated with poor prognosis if complete recanalization cannot be achieved. Endovascular recanalization might be challenging due to difficulties in the safe passage of the occluded plaque at the origin of the internal carotid artery (ICA). The balloon-assisted tracking technique (BAT), where a partially deflated balloon is exposed out of the catheter tip to facilitate its passage through stenosed or spastic arterial segments was introduced by interventional cardiologists and the applicability of the technique has been recently proposed in the field of neurointervention as well. Here we describe our experience using the BAT technique in the endovascular recanalization of tandem occlusive lesions.<br />Methods: Procedures were performed from June 2013 to December 2020 in a single center. Baseline clinical and imaging data, procedural and follow-up details and clinical outcomes were retrospectively collected.<br />Results: In this study 107 patients, median age 66 years, median admission NIHSS 14 and median ASPECTS 8 were included. Successful recanalization of the ICA using the BAT technique was achieved in 100 (93%) and successful intracranial revascularization in 88 (82%) patients. There were no complications attributable to the BAT technique. Intraprocedural complications occurred in 9 (8%) patients. Emergent stenting was performed in 40 (37%) at the end of the procedure. Postprocedural adverse events (intracerebral hemorrhage [ICH], malignant infarction) occurred in 6 (5%) patients. Good clinical outcome at 3 months (modified Rankin scale [mRS] 0-2) was 54 (50%) and mortality 26 (24%). Delayed stent placement during follow-up occurred in 21 cases.<br />Conclusion: Application of BAT technique in tandem occlusions appears feasible, safe, and efficient. Further evaluation of this technique is awaited.<br /> (© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.)
- Subjects :
- Aged
Carotid Artery, Internal diagnostic imaging
Carotid Artery, Internal surgery
Humans
Retrospective Studies
Stents adverse effects
Thrombectomy methods
Treatment Outcome
Arterial Occlusive Diseases complications
Carotid Artery Diseases complications
Endovascular Procedures methods
Ischemic Stroke
Stroke diagnostic imaging
Stroke etiology
Stroke surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1869-1447
- Volume :
- 32
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Clinical neuroradiology
- Publication Type :
- Academic Journal
- Accession number :
- 34546383
- Full Text :
- https://doi.org/10.1007/s00062-021-01078-2