Endovascular treatment of acute stroke with tandem occlusion of internal carotid and middle cerebral artery

2015 ◽  
Vol 357 ◽  
pp. e368-e369
Author(s):  
M. Černá ◽  
M. Köcher ◽  
D. Šaňák ◽  
V. Prášil ◽  
T. Veverka
Keyword(s):  
Endovascular Treatment ◽  
Acute Stroke ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Tandem Occlusion

Natural History of Acute Stroke due to Occlusion of the Middle Cerebral Artery and Intracranial Internal Carotid Artery

2013 ◽  
Vol 24 (4) ◽  
pp. 354-358 ◽  
Author(s):  
María Hernández-Pérez ◽  
Natalia Pérez de la Ossa ◽  
Aitziber Aleu ◽  
Mònica Millán ◽  
Meritxell Gomis ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Natural History ◽  
Internal Carotid Artery ◽  
Acute Stroke ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
History Of

scholarly journals Distance to Thrombus in Endovascular Treatment of Middle Cerebral Artery M1 Occlusion Predicts Recanalization Success and Clinical Outcome

2021 ◽  
Vol 24 (2) ◽  
pp. 113-117
Author(s):  
Nihat Sengeze ◽  
Semih Giray
Keyword(s):  
Endovascular Treatment ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Endovascular Therapy ◽  
Internal Carotid ◽  
Measurement Techniques ◽  
Digital Subtraction ◽  
Stroke Patients ◽  
The Relationship ◽  
Distance To Thrombus

Background: The occlusion site of the cerebral artery can help to determine recanalization success, treatment and prognosis in acute stroke patients. In current studies, different measurement techniques and different length values have been considered. We aimed to determine the relationship between the location of occlusion and recanalization success following endovascular therapy of acute middle cerebral artery (MCA) M1 occlusion. Methods: This study was conducted from January 2015 to March 2019. The "M1 distance-to-thrombus length" was determined on curve-linear reformat reconstruction of the MCA, and measured from the center of internal carotid artery (ICA) bifurcation to the beginning of the thrombus on digital subtraction angiography (DSA). A successful recanalization was defined as ≥ modified thrombolysis in cerebral infarction (mTICI) 2b and full recanalization as mTICI 3. Evaluation of patients at the end of the third month was carried out with modified Rankin Scale (mRS) and mortality. Results: We eventually included 95 patients treated with endovascular therapy. The patients with distance to thrombus (DT) ≤13.2 mm showed significantly higher rates of full recanalization (AUC = 0.639 ± 0.06; P=0.014, 95% confidence interval [CI]). Additionally, DT could predict successful recanalization with an AUC of 0.639. The possibility to distinguish unsuccessful recanalization cases after the endovascular treatment by considering DT had 85.7% sensitivity (95% CI). Of the 82 (86.3%) patients who were treated with successful recanalization (≥mTICI 2b), 46 (48.4%) achieved mRS (0–3) and 38 (40%) expired at the end of the 3 months. Conclusion: Shorter DT was associated with higher rate of full recanalization (mTICI 3) after endovascular therapy. Having a longer DT reduces the chance of successful recanalization without distal embolism. However, there was no statistically significant effect for DT on a favorable outcome at third months or mortality with endovascular treatment of MCA M1 occlusions.

scholarly journals Roentengen-endovascular method of cerebral blood flow restoration in acute tandem occlusion of the internal carotid artery with embolism development in the middle cerebral artery

2016 ◽  
Vol 97 (3) ◽  
pp. 457-460
Author(s):  
M U Volodukhin
Keyword(s):  
Blood Flow ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Terminal Segment ◽  
Acute Thrombosis ◽  
Tandem Occlusion ◽  
Flow Restoration

Aim. This article proposes a roentgen-endosurgical method of performing intracranial arteries revascularization in acute tandem occlusion of the internal carotid artery with the distal embolism development in the middle cerebral artery.Methods. In the period from 2007 to 2014 endovascular revascularization in the internal carotid artery acute thrombosis was performed in 18 patients. Tandem occlusion of the cervical, petrous, cavernous and terminal segments of the internal carotid artery (53.3%) was the most commonly diagnosed. Isolated occlusion of the internal carotid artery cervical segment was determined in 5 (33.3%) patients, of the terminal segment - in 3 (20%) cases. L- and T-types occlusion of the internal carotid artery terminal segment thrombosis frequency were comparable and amounted to 20%. In 5 patients the internal carotid artery tandem occlusion with the distal embolism development in the middle cerebral artery occurred. In this type of injury a method for blood flow restoration in middle cerebral artery without restoring antegrade blood flow in the internal carotid artery was developed and applied.Results. Full blood flow restoration in the middle cerebral artery using this method was achieved in these patients in all cases. Complications associated with the intervention were not registered.Conclusion. The proposed method can be used in patients with the internal carotid artery acute tandem occlusion and the distal embolism development in the middle cerebral artery; the use of this type of revascularization is possible in patients with well-developed communicating arteries that can provide an adequate perfusion volume in the middle cerebral artery.

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