Mechanical thrombectomy in patients with tandem occlusions at University Hospital Southampton: a case series

Inyang, Deborah, Lemke, Lorraine, Marigold, Richard, Adjorlolo, Donald and Siddegowda, Shivaprasad (2024) Mechanical thrombectomy in patients with tandem occlusions at University Hospital Southampton: a case series. European Stroke Journal, 9 (1), [1339]. (doi:10.1177/23969873241245672).

Abstract

Background and aims: acute ischaemic strokes due to tandem occlusions (TO) account for 15-30% of all large-vessel occlusion strokes. Mechanical Thrombectomy (MT) has been associated with positive functional outcomes in TO. We present this case series, detailing the procedural and clinical outcomes of patients with ischaemic strokes secondary to TO who underwent MTs at University Hospital Southampton, UK.

Methods: this is a retrospective review of single-center data from 47 patients with TO who underwent an MT from May 2021 to April 2023. Data regarding clinical presentation, angiographic results, medical treatment, MT procedure, MT outcome, and clinical outcomes were recorded and analysed.

Results: after 6 months 12/47 patients (25.5%) died (mRS 6). Remaining 23/35 patients (68.6%) were successfully followed up: 11 patients had no mRS data recorded, and 1 patient refused MT follow-up. The median mRS at 6 months was 3 (range 0 to 5). Overall, 11/35 (31.4%) patients had a good functional outcome (mRS 0-2), whilst 24/35 (68.6%) patients had poor functional outcomes (mRS 3-5). 14/47 patients (29.8%) experienced post-procedural complications but did not affect the outcome. There was trend towards better functional outcome among patients did not have carotid stent and this group also showed an increased mortality trend compared to those who did not have carotid intervention.

Conclusions: MT resulted in successful reperfusion in 66% of patients with acute stroke secondary to TO, with 48% patients having a good functional outcome at 6 months.

Disclosures of Interest: no.

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