{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T07:13:56Z","timestamp":1776842036134,"version":"3.51.2"},"reference-count":26,"publisher":"BMJ","issue":"e1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2022,8,6]]},"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In patients with mild strokes the risk\u2013benefit ratio of endovascular treatment (EVT) for tandem lesions has yet to be evaluated outside of current guideline recommendations. This study investigates the frequency as well as procedural and safety outcomes in daily clinical practice.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Using data from the German Stroke Registry-Endovascular Treatment (GSR-ET) we analyzed patients with anterior circulation stroke due to tandem-lesions and mild deficits. These patients were defined as \u22645 on the National Institutes of Health Stroke Scale (NIHSS). Recanalization was assessed with the modified Thrombolysis in Cerebral Infarction Scale (mTICI). Early neurological and long-term functional outcomes were assessed with the NIHSS change and modified Rankin scale (mRS), respectively. Safety assessment included periprocedural complications and the rate of symptomatic intracerebral hemorrhage (sICH).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 61 patients met the inclusion criteria and were treated endovascularly for tandem lesions. The median age was 68 (IQR:59\u201376) and 32.9% (20) were female. Patients were admitted to the hospital with a median NIHSS score of 4 (IQR:2\u20135) and a median Alberta Stroke Programme Early CT Score (ASPECTS) of 9 (IQR:8\u201310). Successful recanalization (mTICI 2b-3) was observed in 86.9% (53). NIHSS decreased non-significantly (p=0.382) from baseline to two points (IQR:1\u20139) at discharge. Excellent (mRS\u22641) and favorable (mRS\u22642) long-term functional outcome at 90-days was 55.8% (29) and 69.2% (36), respectively. Mortality rates at 90-days were 9.6% (5) and sICH occurred in 8.2% (5).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>EVT for tandem lesions in patients with mild anterior circulation stroke appears to be feasible but may lead to increased rates of sICH. Further studies comparing endovascular with best medical treatment (BMT) especially investigating the risk of periprocedural hemorrhagic complications, are needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jnis-2022-019239","type":"journal-article","created":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T13:25:27Z","timestamp":1661520327000},"page":"e136-e141","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Endovascular treatment of acute tandem lesions in patients with mild anterior circulation stroke"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct03356392","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04167527","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03796468","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3776-638X","authenticated-orcid":false,"given":"Lukas","family":"Meyer","sequence":"first","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Politi","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, Hospital Bremen-Mitte gGmbH, Bremen, Germany"},{"name":"Interventional Radiology Unit, Evangelismos General Hospital, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Alexandrou","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, Hospital Bremen-Mitte gGmbH, Bremen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5147-2241","authenticated-orcid":false,"given":"Christian","family":"Roth","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, Hospital Bremen-Mitte gGmbH, Bremen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2766-2293","authenticated-orcid":false,"given":"Andreas","family":"Kastrup","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Bremen-Mitte gGmbH, Bremen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasios","family":"Mpotsaris","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, University Hospital of Magdeburg, Magdeburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7543-8555","authenticated-orcid":false,"given":"Uta","family":"Hanning","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8358-8089","authenticated-orcid":false,"given":"Fabian","family":"Flottmann","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caspar","family":"Brekenfeld","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milani","family":"Deb-Chatterji","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Goetz","family":"Thomalla","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5258-2370","authenticated-orcid":false,"given":"Helge","family":"Kniep","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias D","family":"Faizy","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5652-7499","authenticated-orcid":false,"given":"Matthias","family":"Bechstein","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7575-9850","authenticated-orcid":false,"given":"Gabriel","family":"Broocks","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8799-9333","authenticated-orcid":false,"given":"Moriz","family":"Herzberg","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"},{"name":"Institute of Neuroradiology, Ludwig Maximilians Universit\u00e4t, M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Feil","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ludwig Maximilians Universit\u00e4t, M\u00fcnchen, Germany"},{"name":"Department of Neurology and Stroke, Eberhard-Karls University, T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"Kellert","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ludwig Maximilians Universit\u00e4t, M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9093-8307","authenticated-orcid":false,"given":"Franziska","family":"Dorn","sequence":"additional","affiliation":[{"name":"Institute of Neuroradiology, Ludwig Maximilians Universit\u00e4t, M\u00fcnchen, Germany"},{"name":"Department of Neuroradiology, University Hospital Bonn, Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0416-2985","authenticated-orcid":false,"given":"Kamil","family":"Zele\u0148\u00e1k","sequence":"additional","affiliation":[{"name":"Clinic of Radiology, Comenius University's Jessenius Faculty of Medicine and University Hospital, Martin, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8533-7478","authenticated-orcid":false,"given":"Jens","family":"Fiehler","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional 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