Intracranial Occlusion with Tandem Carotid Stenosis: Distal to Proximal Approach

  • Ajit S. PuriEmail author
  • Rajsrinivas Parthasarathy


A 61-year-old man presented with right hemiplegia and aphasia. NIH stroke scale was 20. The ASPECTS score was 9, and CT angiogram showed occlusion at the origin of the left internal carotid artery and left M1–MCA occlusion. He was started on IV tPA and transferred for endovascular management.

Suggested Reading

  1. Marnat G, et al. Endovascular management of tandem occlusion stroke related to internal carotid artery dissection using a distal to proximal approach: insight from the RECOST study. AJNR Am J Neuroradiol. 2016;37(7):1281–8.CrossRefGoogle Scholar
  2. Rangel-Castilla L, et al. Management of acute ischemic stroke due to tandem occlusion: should endovascular recanalization of the extracranial or intracranial occlusive lesion be done first? Neurosurg Focus. 2017;42(4):E16.CrossRefGoogle Scholar
  3. Spiotta AM, et al. Proximal to distal approach in the treatment of tandem occlusions causing an acute stroke. J Neurointerv Surg. 2015;7(3):164–9.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2019

Authors and Affiliations

  1. 1.Radiology, and Neurosurgery, Division of Neurointerventional Surgery, Neurointerventional Fellowship ProgramUniversity of Massachusetts Medical CenterWorcesterUSA
  2. 2.Vascular Neurology and Neurointerventional SurgeryArtemis Agrim Institute of NeuroscienceGurgaonIndia

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