- 期刊
- OpenAccess
Management of Acute Ischemic Stroke Caused by Tandem Lesions Successfully Treated With Intracranial Thrombectomy Without Cervical Stenting: A Case Report and Literature Review
摘要
Tandem lesions refer to the simultaneous presence of an intracranial occlusion within the anterior circulation and high-grade ipsilateral stenosis or occlusion of the cervical internal carotid artery. Intracranial thrombectomy is central to treating tandem lesions. However, it is not known whether performing the intracranial thrombectomy before or after dealing with the cervical lesion leads to different outcomes. In addition, there is no consensus in choosing an optimal treatment strategy, whether it be acute stenting, angioplasty, or conservative treatment for the cervical lesion. We report the procedure and outcome of a case with tandem lesions at the M1 segment of the right middle cerebral artery and innominate artery that was treated with an intracranial-first thrombectomy. Initially, the pre-procedure therapeutic strategy for this case was to treat the cervical tandem occlusion extracranially first, but this was unsuccessful. The intracranial thrombus was resolved; however, the extracranial thrombus in the innominate artery remained because we failed to retrieve it. Therefore, we present this case report with a literature review describing therapeutic strategies for tandem lesion occlusions. The published literature revealed no consensus or optimized protocol for treating tandem occlusions; this issue thus requires further study.
延伸閱讀
- 蔡惠如、宋昇峯（2019）。Infective Endocarditis Presented with Intracranial Hemorrhage Followed by Ischemic Stroke: A Case Report。台灣專科護理師學刊，6(2)，78-85。https://www.airitilibrary.com/Article/Detail?DocID=P20150413001-201912-202002140008-202002140008-78-85
- Gong, X., Zou, X., Liu, L., Pu, Y., Wang, Y., Pan, Y., Soo, Y. O. Y., Leung, T. W. H., Zhao, X., Wang, Y., & Wong, K. S. (2013). Prognostic Value of Inflammatory Mediators in 1-Year Outcome of Acute Ischemic Stroke with Middle Cerebral Artery Stenosis. Mediators of Inflammation, 2013(), 913-919-300. https://doi.org/10.1155/2013/850714
- Meng, S. W., Kuo, R. C., Yang, H. J., Lai, C. L., Wu, C. C., & Hsieh, M. Y. (2018). Recruiting an Acute Coronary Team to Perform Emergent Mechanical Thrombectomy in Acute Ischemic Stroke Patients: A Successful Case and Team Model in a Local Hospital. Acta Cardiologica Sinica, 34(1), 99-103. https://doi.org/10.6515/ACS.201801_34(1).20170730A
- 蕭詩立、曾愉婷、沈雅敏、蕭詩如（2018）。Management of Ischemic Stroke with Idarucizumab and Systemic Thrombolysis: Case Report。臺灣臨床藥學雜誌，26(1)，75-79。https://doi.org/10.6168/FJCP.201801_26(1).0009
- 朱永載、陳志昊、林彥亨、李崇維、蔡力凱、湯頌君、鄭建興（2021）。Rare Complications of Endovascular Thrombectomy for Acute Ischemic Stroke: Case Series。台灣中風醫誌，3(3)，147-154。https://doi.org/10.6318/FJS.202109_3(3).0004