{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T20:52:29Z","timestamp":1759179149934,"version":"3.44.0"},"reference-count":14,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2020,6,4]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Mechanical thrombectomy with a stent retriever (SR) and\/or aspiration is the \"gold standard\" for the treatment of acute ischemic stroke due to large vessel occlusion (LVO). However, sometimes clots may not be retrievable with a single SR alone or combined with aspiration.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To assess the safety and efficacy of a novel tandem stents thrombectomy (TST) technique as a rescue treatment for acute LVO that is refractory to conventional attempts.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>All patients treated with the TST technique as rescue treatment after failure of conventional attempts were retrospectively reviewed. The postprocedural angiographic and clinical outcome, including modified Thrombolysis in Cerebral infarction (mTICI) grade, National Institutes of Health Stroke Scale (NIHSS) score, and modified Rankin Scale (mRS) score, was assessed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Nine patients (mean age, 65.2 years; median NIHSS score 18) with middle cerebral artery M1 segment (n=6) and terminal internal carotid artery (n=3) occlusions were included in the study. The TST technique was performed as a rescue treatment after unsuccessful stent thrombectomy alone (four cases) and stent thrombectomy plus aspiration (five cases). Successful recanalization (mTICI 2b\/3) was achieved in all patients. No procedure-related complications occurred except reversible vasospasms were observed in three patients and one patient developed hemorrhage transformation after the procedure, but was asymptomatic. Three patients had good clinical outcome (mRS score 0\u20132 at 90 days). Two patients (22.2%) died.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The TST technique seems to be a safe and effective rescue treatment for acute LVO that is refractory to conventional attempts.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/neurintsurg-2020-015822","type":"journal-article","created":{"date-parts":[[2020,7,8]],"date-time":"2020-07-08T17:15:35Z","timestamp":1594228535000},"page":"33-38","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Tandem stents thrombectomy as a rescue treatment for refractory large vessel occlusions"],"prefix":"10.1136","volume":"13","author":[{"given":"Haowen","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Neurointerventional Radiology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shanling","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Emergency, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Quan","sequence":"additional","affiliation":[{"name":"Department of Neurointerventional Radiology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongjie","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Neurointerventional Radiology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zibo","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurointerventional Radiology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7367-2735","authenticated-orcid":false,"given":"Xiaojie","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Neurointerventional Radiology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaihao","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Neurointerventional Radiology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guo","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurointerventional Radiology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheng","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Neurointerventional Radiology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panxing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurointerventional Radiology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,7,8]]},"reference":[{"key":"2025092913064179000_13.1.33.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1411587"},{"key":"2025092913064179000_13.1.33.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414792"},{"key":"2025092913064179000_13.1.33.3","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000258112.14918.24"},{"key":"2025092913064179000_13.1.33.4","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1016\/S0140-6736(12)61384-1","article-title":"Solitaire flow restoration device versus the Merci 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Lancet"},{"key":"2025092913064179000_13.1.33.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)08020-9"},{"key":"2025092913064179000_13.1.33.8","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3746"},{"key":"2025092913064179000_13.1.33.9","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2017-013394"},{"key":"2025092913064179000_13.1.33.10","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2018-014288"},{"key":"2025092913064179000_13.1.33.11","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.024442"},{"key":"2025092913064179000_13.1.33.12","first-page":"32910","article-title":"Stent expansion and in-stent thrombus sign in the Trevo stent retriever predict recanalization and possible etiology during mechanical thrombectomy: a case series of 50 patients with acute middle cerebral artery occlusion","author":"Imahori","year":"2018","journal-title":"World 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