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Differences in risk factors and outcome after acute stroke in patients with tandem occlusion and those with isolated intracranial occlusion after endovascular treatment

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Abstract

Objective

This study aimed to compare the clinical features, treatment, and clinical outcome of patients with tandem occlusion and isolated intracranial occlusion through endovascular treatment (EVT).

Methods

Patients with acute cerebral infarction who received EVT in two stroke centers were retrospectively included. According to MRI or CTA results, the patients were divided into tandem occlusion group or isolated intracranial occlusion group. The baseline data, etiological classification, treatment, post-stroke complications, image features, and clinical outcome were compared. Multivariate logistic regression analysis was used to evaluate the related factors affecting the prognosis of patients with EVT.

Results

Among 161 patients with acute cerebral infarction, there were 33 cases (20.5%) in the tandem occlusion group and 128 cases (79.5%) in the isolated intracranial occlusion group. Compared with isolated intracranial occlusion, the patients with tandem occlusion had higher rates of large artery atherosclerosis (P = 0.028), symptomatic intracerebral hemorrhage (sICH) (P = 0.023), bilateral infarction (P = 0.042), and longer time for endovascular procedure (P = 0.026). There was no significant statistical difference in 90-day mRS score between the two groups (P = 0.060). Multivariate logistic regression identified the following independent predictors of poor functional outcome: older age, high fasting blood glucose, infarction area > 1/3, and hemorrhagic transformation.

Conclusions

Compared with isolated intracranial occlusion, there was not a worse prognosis among patients with tandem occlusion who received EVT.

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Data availability

Data are available on reasonable request. Further enquiries can be directed to the corresponding author.

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Funding

This study was supported by middle-aged academic and technical Training Project for High-Level Talents (202105AC160065) and National Natural Science Foundation of China (82060230) and Yunnan Training Project for High-Level Talents (RLQB20200003).

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Authors and Affiliations

  1. Department of Neurology, Hospital of Kunming Medical University, No. 295 Xi Chang Lu, Kunming, 650032, Yunnan Province, China

    Shihan Lin, Yongyu Li, Chunyan Lei, Xinlian Zhou, Xiaoyan Zhu, Xinglong Yang & Chun Chen

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  1. Shihan Lin
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  2. Yongyu Li
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  3. Chunyan Lei
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  4. Xinlian Zhou
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Contributions

Chunyan Lei designed the subject. Yongyu Li, Xianlian Zhou, Shihan Lin, Xiaoyan Zhu collected and extracted data the article. Xinglong Yang and Chun Chen revised the important intelligent content. Shihan Lin drafted the manuscript. Chunyan Lei approved the final version of the manuscript.

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Correspondence to Chunyan Lei.

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The authors declare no competing interests.

Ethics approval

The study protocol was designed in accordance with international ethics criteria for human research and was approved by the Scientific Research Department of First Affiliated Hospital of Kunming Medical University.

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The written informed consents to all participants including vulnerable participants in the study had been obtained from themselves (or their parents/ legal guardians/ next of kins).

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None of the authors had any conflict of interest with any pharmaceutical companies or organizations in carrying out this study.

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Lin, S., Li, Y., Lei, C. et al. Differences in risk factors and outcome after acute stroke in patients with tandem occlusion and those with isolated intracranial occlusion after endovascular treatment. Neurosurg Rev 46, 103 (2023). https://doi.org/10.1007/s10143-023-02013-4

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  • DOI: https://doi.org/10.1007/s10143-023-02013-4

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