Milazzo Nicola, Da Ros Valerio, Diomedi Marina, Menozzi Roberto, Pezzini Alessandro, Ruggiero Maria, Simonetti Luigi, Zini Andrea, Romano Daniele Giuseppe, Napoletano Rosa, Vallone Stefano, Bigliardi Guido, Plebani Mauro, Cappellari Manuel, Cristaudo Concetto, Mangiafico Salvatore, Toni Danilo, Consoli Arturo
Diagnostic and Interventional Neuroradiology, Foch Hopital, Suresnes, France.
UFR Simon Veil Santé, University of Versailles Saint-Quentin-en-Yvelines (UVSQ), Montigny-Le-Bretonneux, France.
Neurol Sci. 2025 Jan;46(1):277-284. doi: 10.1007/s10072-024-07722-2. Epub 2024 Aug 19.
Although a benefit from mechanical thrombectomy has been proven, the best treatment strategy for tandem occlusions (TOs) remains unclear. We conducted a survey that aimed to investigate the trends of pharmacological strategy in the setting of emergent carotid stenting for TOs in the Italian neuro-endovascular community.
We administered a 13-multiple choice-questions survey to the Chiefs of the centers participating to the Italian Registry of Endovascular Thrombectomy in Acute Stroke (IRETAS), focused on the technical aspects and on the management of the antiplatelet therapy for emergent carotid tenting in TOs. An internal coherence control was performed by the coordinating investigator.
We obtained responses from 56/66 centers (84.8%). The main results of the survey showed that most of the center treat TOs using a retrograde approach, deploying a closed-cell stent. A single antiplatelet therapy is preferred at the moment of the deployment of the stent.
This survey showed that the current practice regarding the acute management of TOs, in particular the antiplatelet therapy, remains heterogeneous in the Italian neurovascular community. Specific evidences are urgently needed in order to achieve a consensus on the acute management of TOs.
尽管机械取栓的益处已得到证实，但串联闭塞（TOs）的最佳治疗策略仍不明确。我们开展了一项调查，旨在探究意大利神经血管内介入领域针对TOs进行急诊颈动脉支架置入时的药物治疗策略趋势。
我们向参与意大利急性卒中血管内取栓注册研究（IRETAS）的各中心主任发放了一份包含13道多项选择题的调查问卷，重点关注技术方面以及TOs急诊颈动脉支架置入时抗血小板治疗的管理。由协调调查员进行内部一致性控制。
我们收到了66个中心中56个中心（84.8%）的回复。调查的主要结果显示，大多数中心采用逆行方法治疗TOs，使用闭孔型支架。在支架置入时，更倾向于单一抗血小板治疗。
这项调查表明，在意大利神经血管领域，目前关于TOs急性处理的做法，尤其是抗血小板治疗，仍然存在差异。迫切需要具体证据，以便就TOs的急性处理达成共识。
