Эндоваскулярное лечение пациентов с острым ишемическим инсультом, вызванным тандемным поражением внутренней сонной артерии

Endovascular treatment of patients with acute ischemic stroke caused by tandem lesion of the internal carotid artery

Aim – to investigate the results of endovascular treatment of patients with acute ischemic stroke due to tandem lesions of the internal carotid artery (ICA), to identify predictors of favorable functional outcome and to determine the optimal strategy of endovascular treatment in this cohort of patients. Materials and methods. This study included 94 patients with acute ischemic stroke caused by tandem lesions of the ICA. After achieving successful intracranial reperfusion (mTICI 2b-3), all patients were divided into two groups. In the stenting group (n = 48), patients received emergency stenting of the ICA. In the non-stenting group (n = 46), patients were prescribed best medical therapy. The Stattech statistical program was used to evaluate the obtained data. Results. The frequency of favorable functional outcome after 90 days (mRs 0-2) in the stenting and non-stenting groups was 64.6% and 41.3%, respectively (p = 0.024); there was also a statistically significant difference in the patency of the extracranial ICA in the stenting and non-stenting groups – 89.6% and 67.4%, respectively (p = 0.009). Extracranial ICA patency was a predictor of favorable functional outcome (p = 0.019) and survival at three months (p = 0.032). In the stenting group, early neurologic improvement (odds ratio (OR) 3.419; 95% confidence interval (CI) 1.465 – 7.978, p = 0.004) and significant neurologic improvement at day 7 (OR 2.604; 95% CI 1.132 – 5.986, p < 0.023) were significantly more frequent. Conclusion. In the stenting group patients significantly more often achieved a favorable functional outcome within three months, as well as in the stenting group patency of the extracranial ICA, early neurological improvement and significant neurological improvement at day 7 were noted significantly more often. This study showed that endovascular thrombectomy from intracranial large vessel occlusion in combination with emergency stenting of the ICA is the most effective endovascular method of treatment of patients with acute ischemic stroke caused by tandem lesion of the ICA. © Коллектив авторов, 2025