The efficacy of various interventions to the extracranial stenosis on reperfusion in anterior tandem lesions receiving mechanical thrombectomy

Objective To evaluate the efficacy of different interventions to the extra cranial lesions in acute ischemic stroke (AIS) due to anterior tandem lesions (TL) on reperfusion. Methods As a multi-center, cross-sectional study, AIS due to anterior TL receiving mechanical thrombectomy (MT) were retrospectively collected. Interventions to the extra-cranial stenosis were recorded. Post-procedural reperfusion was assessed using the modified thrombolysis in cerebral infarction (mTICI) score. Complete revascularization was defined as mTICI 3 and good revascularization was defined as mTICI 2b/3. The relationship between different extra-cranial intervention regimens and rate of re-vascularization was compared. Results Totally 117 patients were included with 92.3% reaching good recanalization and 63.2% reaching complete re-canalization. There was no significant difference in good re-canalization rates among various extra-cranial intervention regimens. The rate of complete re-canalization was significantly higher in patients receiving endovascular therapy(P＜0.05) and there was significant difference among various endovascular treatment regimens(P＜0.01): acute balloon angioplasty only group presented the highest rate of complete re-canalization (100.0%), followed by acute stenting only group (80%), acute stenting + balloon angioplasty group (73.7%) and conservative treatment group (54.3%). Conclusions Endovascular intervention to extra-cranial stenosis contributes to complete re-canalization in AIS due to anterior TL receiving MT, and acute balloon angioplasty seems to be quite effective than acute stenting.