PT  - JOURNAL ARTICLE
AU  - A.Y. Poppe
AU  - G. Jacquin
AU  - D. Roy
AU  - C. Stapf
AU  - L. Derex
TI  - Tandem Carotid Lesions in Acute Ischemic Stroke: Mechanisms, Therapeutic Challenges, and Future Directions
AID  - 10.3174/ajnr.A6582
DP  - 2020 Jul 01
TA  - American Journal of Neuroradiology
PG  - 1142--1148
VI  - 41
IP  - 7
4099  - http://www.ajnr.org/content/41/7/1142.short
4100  - http://www.ajnr.org/content/41/7/1142.full
SO  - Am. J. Neuroradiol.2020 Jul 01; 41
AB  - SUMMARY: Approximately 15% of patients undergoing endovascular thrombectomy for anterior circulation acute ischemic stroke have a tandem lesion, defined as a severe stenosis or occlusion of the cervical internal carotid artery ipsilateral to its intracranial occlusion. Patients with tandem lesions have worse outcomes than patients with isolated intracranial occlusions, but the optimal management of their carotid lesions during endovascular thrombectomy remains controversial. The main options commonly used in current practice include acute stent placement in the carotid lesion versus thrombectomy alone without definitive revascularization of the carotid artery. While treatment decisions for these patients are often complex and strategies vary according to clinical, anatomic, and technical considerations, only results from randomized trials comparing these approaches are likely to strengthen current recommendations and optimize patient care.AISacute ischemic strokec-ICAcervical internal carotid arteryEVTendovascular thrombectomyIVTintravenous thrombolysisTLtandem lesion