{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:26:24Z","timestamp":1792193184029,"version":"4.4.0"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Purpose\u2014<\/jats:title>\n                    <jats:p>Emergent carotid artery stenting plus mechanical thrombectomy is an effective treatment for acute ischemic stroke patients with tandem occlusion of the anterior circulation. However, there is limited data supporting the safety of this approach in patients treated with prior intravenous thrombolysis (IVT). We aimed to investigate the safety of emergent carotid artery stenting-mechanical thrombectomy approach in stroke patient population treated with prior IVT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods\u2014<\/jats:title>\n                    <jats:p>We assessed patients with acute ischemic stroke because of atherosclerotic tandem occlusion that were treated with emergent carotid artery stenting-mechanical thrombectomy approach from the multicenter observational Thrombectomy in Tandem Lesions registry. Patients were divided into 2 groups based on pretreatment IVT (IVT versus no-IVT). Intracerebral hemorrhages were classified according to the European Cooperative Acute Stroke Study II criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results\u2014<\/jats:title>\n                    <jats:p>\n                      Among 205 patients included in the present study, 125 (60%) received prior IVT. Time from symptoms onset-to-groin puncture was shorter (234\u00b1100 versus 256\u00b1234 minutes;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.002), and heparin use was less in the IVT group (14% versus 35%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001); otherwise, there was no difference in the baseline characteristics. There was no significant difference between the IVT and no-IVT groups in the rate of symptomatic intracerebral hemorrhage (5% versus 8%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.544), parenchymal hematoma type 1 to 2 (15% versus 18%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.647), successful reperfusion (modified Thrombolysis in Cerebral Ischemia 2b\u20133), or 90-day favorable outcome (modified Rankin Scale score of 0\u20132 at 90 days). The 90-day all-cause mortality rate was significantly lower in the IVT group (8% versus 20%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.017). After adjusting for covariates, IVT was not associated with symptomatic intracerebral hemorrhage or 90-day mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>Emergent carotid artery stenting-mechanical thrombectomy approach was not associated with an increased risk of hemorrhagic complications in tandem occlusion patients who received IVT before the intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.118.024733","type":"journal-article","created":{"date-parts":[[2019,6,17]],"date-time":"2019-06-17T05:00:20Z","timestamp":1560747620000},"page":"2250-2252","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":84,"title":["Emergent Carotid Stenting Plus Thrombectomy After Thrombolysis in Tandem Strokes"],"prefix":"10.1161","volume":"50","author":[{"given":"Mohammad","family":"Anadani","sequence":"first","affiliation":[{"name":"From the Department of Neurosurgery, Medical University of South Carolina, Charleston (M.A., A.M.S., A.A.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro M.","family":"Spiotta","sequence":"additional","affiliation":[{"name":"From the Department of Neurosurgery, Medical University of South Carolina, Charleston (M.A., A.M.S., A.A.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Alawieh","sequence":"additional","affiliation":[{"name":"From the Department of Neurosurgery, Medical University of South Carolina, Charleston (M.A., A.M.S., A.A.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Turjman","sequence":"additional","affiliation":[{"name":"Department of Interventional Neuroradiology, Hospices Civils de Lyon, France (F.T.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Piotin","sequence":"additional","affiliation":[{"name":"Department of Interventional Neuroradiology, Paris, France (M.P., M.M.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diogo C.","family":"Haussen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Emory University\/Grady Memorial Hospital, Atlanta (R.G.N., D.C.H.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul G.","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Department of Neurology, Emory University\/Grady Memorial Hospital, Atlanta (R.G.N., D.C.H.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Papanagiotou","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Neuroradiology, Hospital Bremen-Mitte\/Bremen-Ost, Deutschland (P.P.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adnan H.","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, State University of New York, Buffalo (A.H.S.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Lapergue","sequence":"additional","affiliation":[{"name":"Department of Neurology, Stroke Center, Foch Hospital, Suresnes, France (B.L.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Dorn","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, University Hospital of Munich, Germany (F.D.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Cognard","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, University Hospital of Toulouse, France (C.C.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Ribo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Vall D\u2019Hebron, Barcelona, Spain (M.R.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marios N.","family":"Psychogios","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, University Medical Center G\u00f6ttingen, Germany (M.P.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc Antoine","family":"Labeyrie","sequence":"additional","affiliation":[{"name":"Department of Interventional Neuroradiology, Lariboisi\u00e8re Hospital, Paris, France (M.A.L.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikael","family":"Mazighi","sequence":"additional","affiliation":[{"name":"Department of Interventional Neuroradiology, Paris, France (M.P., M.M.)"},{"name":"Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France 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of emergent cervical carotid stenting in tandem occlusion strokes treated by thrombectomy: a review of the TITAN collaboration.","volume":"10","author":"Zhu F","year":"2019","unstructured":"Zhu, F, Bracard, S, Anxionnat, R, Derelle, AL, Tonnelet, R, Liao, L, et al. Impact of emergent cervical carotid stenting in tandem occlusion strokes treated by thrombectomy: a review of the TITAN collaboration. Frontiers in Neurology. 2019;10:206.","journal-title":"Frontiers in Neurology"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.05.036"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4459"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13577"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.017320"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000005299"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000110219.67054.BF"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.118.024733","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T12:39:20Z","timestamp":1762864760000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.118.024733"}},"subtitle":["Analysis of the TITAN Registry"],"short-title":[],"issued":{"date-parts":[[2019,8]]},"references-count":9,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1161\/STROKEAHA.118.024733"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.118.024733","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8]]},"assertion":[{"value":"2018-12-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-21","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}