Le Thang Minh, Tran Dang Ngoc, Nguyen Giang Luu, Nguyen Nam Hoai, Nguyen Tran Tran, Nguyen Hai Ngoc, Bao Tran Luan Minh
Department of Cardiovascular and Thoracic Surgery, University of Medicine and Pharmacy at Ho Chi Minh city, Viet Nam.
Digital Subtraction Angiography Unit, Can Tho S.I.S. General Hospital, Can Tho city, Viet Nam.
J Taibah Univ Med Sci. 2025 May 9;20(3):280-287. doi: 10.1016/j.jtumed.2025.04.003. eCollection 2025 Jun.
Rescue carotid stenting has recently been provided as an additional treatment followed by mechanical thrombectomy in patients with tandem occlusions of the anterior circulation. Nevertheless, few available data support the benefits of this treatment in Asia. We hypothesized that this treatment would be associated with improved postprocedural clinical outcomes.
We retrospectively analyzed patients who underwent rescue carotid stenting for tandem occlusions of the anterior circulation between December 2020 and May 2024 at our hospital. Clinical, neuroimaging, procedural, and complication data were collected. Primary outcomes included the rate of good outcomes with the modified Rankin Scale (mRS) ≤2 at 3-month follow-up.
Ninety patients with tandem occlusions of the anterior circulation who underwent rescue carotid stenting were included, all of whom achieved successful recanalization. Among the 80 cases with the distal-to-proximal approach, diagnostic-Dotter was used in 85 %. Fifty-three patients (58.9 %) had good outcomes, and six patients (6.7 %) experienced parenchymal hemorrhage type II, which was associated with death (mRS 6) after the procedure.
Placement of rescue carotid stenting in tandem occlusions was associated with improved clinical outcomes, without increasing symptomatic intracranial hemorrhage.
对于前循环串联闭塞患者，补救性颈动脉支架置入术最近已作为机械取栓术后的一种额外治疗方法。然而，在亚洲，很少有现有数据支持这种治疗方法的益处。我们假设这种治疗方法将与术后临床结局的改善相关。
我们回顾性分析了2020年12月至2024年5月在我院接受前循环串联闭塞补救性颈动脉支架置入术的患者。收集了临床、神经影像学、手术及并发症数据。主要结局包括3个月随访时改良Rankin量表（mRS）评分≤2的良好结局发生率。
纳入90例接受前循环串联闭塞补救性颈动脉支架置入术的患者，所有患者均成功再通。在80例采用由远及近方法的病例中，85%使用了诊断性Dotter技术。53例患者（58.9%）获得良好结局，6例患者（6.7%）发生Ⅱ型实质内出血，这与术后死亡（mRS 6）相关。
在前循环串联闭塞中置入补救性颈动脉支架与临床结局改善相关，且未增加有症状颅内出血的发生。
