{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T22:37:49Z","timestamp":1776724669964,"version":"3.51.2"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,2,9]],"date-time":"2013-02-09T00:00:00Z","timestamp":1360368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Endovascular therapy is used increasingly for treatment of acute symptomatic internal carotid artery (<jats:styled-content style=\"fixed-case\">ICA<\/jats:styled-content>) occlusion, although randomized trials are lacking. Predictors of outcome are therefore of special interest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From 1992 to 2010 we treated 201 patients with acute <jats:styled-content style=\"fixed-case\">ICA<\/jats:styled-content> occlusion with intra\u2010arterial pharmacological thrombolysis (32), endovascular mechanical therapy (78) or a combination of both (91). All data were assessed prospectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 76\/38% patients with tandem occlusions [<jats:styled-content style=\"fixed-case\">ICA<\/jats:styled-content> plus middle (<jats:styled-content style=\"fixed-case\">MCA<\/jats:styled-content>) or anterior cerebral arteries (<jats:styled-content style=\"fixed-case\">ACA<\/jats:styled-content>)], 18\/9% without concomitant occlusions of major intracranial arteries (<jats:styled-content style=\"fixed-case\">ICA<\/jats:styled-content> plus branch occlusion) and 107\/53% with functional <jats:styled-content style=\"fixed-case\">ICA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">T<\/jats:styled-content> occlusions (<jats:styled-content style=\"fixed-case\">ICA<\/jats:styled-content> plus <jats:styled-content style=\"fixed-case\">MCA<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">ACA<\/jats:styled-content>). Median baseline National Institute of Health Stroke Scale (<jats:styled-content style=\"fixed-case\">NIHSS<\/jats:styled-content>) score was 17. Good recanalization (<jats:styled-content style=\"fixed-case\">Thrombolysis in Myocardial Infarction<\/jats:styled-content> 2\u20133) was achieved in (157\/201) 78% patients and good reperfusion (<jats:styled-content style=\"fixed-case\">Thrombolysis in Cerebral Infarction<\/jats:styled-content> 2\u20133) in (151\/182) 83%. Better recanalization rates were obtained with mechanical approaches, with\/without thrombolytics (78\/91\u2005=\u200586% and 64\/78\u2005=\u200582%) compared with pharmacological thrombolysis only (15\/32\u00a0=\u00a047%; <jats:italic>P\u2005<\/jats:italic>&lt;\u20050.001). Twelve patients (6%) suffered symptomatic intracranial haemorrhages. The 3\u2010month outcome was favourable [modified Rankin score (<jats:styled-content style=\"fixed-case\">mRS<\/jats:styled-content>) 0\u20132] in 54\/28% patients and moderate (<jats:styled-content style=\"fixed-case\">mRS<\/jats:styled-content> 0\u20133) in 90\/46%; 60\/31% patients died. Only 17\/16% patients with functional <jats:styled-content style=\"fixed-case\">ICA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">T<\/jats:styled-content> occlusions had favourable outcomes compared with 32\/44% with tandem occlusions and 5\/31% with <jats:styled-content style=\"fixed-case\">ICA<\/jats:styled-content> plus cerebral branch occlusions (<jats:italic>P\u2005<\/jats:italic>=\u20050.001). In multivariate analysis age [odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>)\u2005=\u20050.96, 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>)\u2005=\u20050.93\u20130.98], <jats:styled-content style=\"fixed-case\">NIHSS<\/jats:styled-content> on admission (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u2005=\u20050.9, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u2005=\u20050.83\u20130.98) and functional <jats:styled-content style=\"fixed-case\">ICA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">T<\/jats:styled-content> occlusion (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u2005=\u20050.35, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u2005=\u20050.16\u20130.77) were non\u2010modifiable predictors, and vessel recanalization was the only modifiable predictor of outcome (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u2005=\u20059.30, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u2005=\u20052.03\u201342.63).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The outcome of acute symptomatic <jats:styled-content style=\"fixed-case\">ICA<\/jats:styled-content> occlusion is poor. However, recanalization is associated with better outcome, and recanalization rates with mechanical techniques were superior to merely pharmacological recanalization attempts.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.12094","type":"journal-article","created":{"date-parts":[[2013,2,9]],"date-time":"2013-02-09T08:22:35Z","timestamp":1360398155000},"page":"1017-1024","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":70,"title":["Endovascular therapy in 201 patients with acute symptomatic occlusion of the internal carotid artery"],"prefix":"10.1111","volume":"20","author":[{"given":"U.","family":"Fischer","sequence":"first","affiliation":[{"name":"Department of Neurology Inselspital University Hospital Bern University of Bern Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.\u2010L.","family":"Mono","sequence":"additional","affiliation":[{"name":"Department of Neurology Inselspital University Hospital Bern University of Bern Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Schroth","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology Inselspital University Hospital Bern University of Bern Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Neurology Inselspital University Hospital Bern University of Bern Bern Switzerland"},{"name":"Department of Neuroradiology Inselspital University Hospital Bern University of Bern Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Mordasini","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology Inselspital University Hospital Bern University of Bern Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"El\u2010Koussy","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology Inselspital University Hospital Bern University of Bern Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Weck","sequence":"additional","affiliation":[{"name":"Department of Neurology Inselspital University Hospital Bern University of Bern Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Brekenfeld","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology Inselspital University Hospital Bern University of Bern Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.","family":"Findling","sequence":"additional","affiliation":[{"name":"Department of Neurology Inselspital University Hospital Bern University of Bern Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Galimanis","sequence":"additional","affiliation":[{"name":"Department of Neurology Inselspital University Hospital Bern University of Bern Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. 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