Endovascular therapy of acute ischemic stroke related to tandem occlusion: comparison of occlusion and severe stenosis of the proximal cervical internal carotid artery

Objective:Strokes related to tandem occlusions of the internal carotid artery (ICA) and a major intracranial artery are associated with poor clinical outcome. We evaluated the clinical efficacy of endovascular approach for the management of these lesions. We also compared the clinical outcomes regarding the type of cervical ICA lesions; complete occlusion vs severe stenosis.Methods:We retrospectively reviewed 42 patients with acute ischemic stroke who underwent endovascular treatment for tandem lesions between January 2011 and April 2017. After dividing the patients into two groups according to lesion type of the proximal cervical ICA (complete occlusion and severe stenosis), we analyzed demographic data, angiographic findings and clinical outcomes. A modified Rankin Scale score ≤2 was defined as a favorable clinical outcome.Results:Of 42 patients, 27 patients (64.3%) had complete occlusion of the cervical ICA, and the remaining 15 had high-grade stenosis. Successful stenting was performed in all patients...