{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T23:03:06Z","timestamp":1782169386423,"version":"3.54.5"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>The optimal endovascular management of cervical carotid dissection causing tandem occlusion remains uncertain. We investigated the impact of emergent carotid stenting during endovascular treatment for acute ischemic stroke in patients with tandem occlusion secondary to cervical carotid artery dissection.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>This was a secondary analysis of patients treated with endovascular treatment for acute ischemic stroke due to occlusive carotid artery dissection and tandem occlusion included in the retrospective international STOP-CAD study (Antithrombotic Treatment for Stroke Prevention in Cervical Artery Dissection). We compared patients with and without emergent stenting. The primary efficacy and safety outcomes were 90-day functional independence (modified Rankin Scale score, 0\u20132) and symptomatic intracranial hemorrhage within 24 hours after endovascular treatment. Procedural outcome was successful intracranial recanalization (modified Thrombolysis in Cerebral Infarction score of 2b\/3). We used mixed-effects logistic regression adjusting for site, age, and National Institutes of Health Stroke Scale. In additional analyses, we used inverse probability of treatment weighting and adjusted for Alberta Stroke Program Early CT Score.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Of the 4023 patients enrolled in STOP-CAD, 328 presented with anterior circulation acute ischemic stroke due to tandem occlusion and underwent endovascular treatment. The median age was 51 (interquartile range, 44\u201358) years, and 96 patients (29.3%) were female. One hundred fifty patients (45.7%) underwent emergent stenting. There was no significant association between stenting and 90-day functional independence (62.0% versus 59.7%; adjusted odds ratio, 1.23 [95% CI, 0.82\u20131.86];\n              <jats:italic>P<\/jats:italic>\n              =0.315) or symptomatic intracranial hemorrhage (7.3% versus 7.9%; adjusted odds ratio, 0.95 [95% CI, 0.41\u20132.2];\n              <jats:italic>P<\/jats:italic>\n              =0.913). Emergent carotid stenting was associated with successful intracranial recanalization (81.8% versus 76.6%; adjusted odds ratio, 2.62 [95% CI, 1.52\u20134.5];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Results did not meaningfully change in additional analyses.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>In patients presenting with an acute anterior circulation tandem occlusion secondary to cervical carotid artery dissection, emergent stenting was associated with a higher likelihood of successful intracranial recanalization but not improved functional outcomes or increased symptomatic intracranial hemorrhage. It remains unclear whether emergent stenting led to successful intracranial recanalization or patients with successful intracranial recanalization were more likely to be stented. Randomized trials are warranted.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.124.048295","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T10:01:26Z","timestamp":1738231286000},"page":"808-817","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Emergent Carotid Stenting During Thrombectomy in Tandem Occlusions Secondary to Dissection: A STOP-CAD Secondary Study"],"prefix":"10.1161","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5199-6210","authenticated-orcid":true,"given":"Jo\u00e3o Andr\u00e9","family":"Sousa","sequence":"first","affiliation":[{"name":"Department of Neurology, Centro Hospitalar e Universit\u00e1rio de Coimbra, Unidade Local de Sa\u00fade de Coimbra, Portugal (J.A.S., V.B., S.B.-C., J.S.-F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7953-3795","authenticated-orcid":true,"given":"Marc","family":"Rodrigo-Gisbert","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Vall d\u2019Hebron, Barcelona, Spain (M.R.-G., M. Requena)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9784-8475","authenticated-orcid":true,"given":"Liqi","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Brown Medical School, Providence, RI (L.S., D.M.M., S.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7620-1509","authenticated-orcid":true,"given":"Anqi","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Neurology, UT Health San Antonio, TX (A.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6770-7700","authenticated-orcid":true,"given":"Han","family":"Xiao","sequence":"additional","affiliation":[{"name":"Economics Department, University of California, Santa Barbara (H.X.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0364-826X","authenticated-orcid":true,"given":"Noor A.","family":"Mahmoud","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Oklahoma (N.A.M., A.L.O.S., F.S.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2979-9496","authenticated-orcid":true,"given":"Asghar","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI (A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Luyza","family":"Oliveira Santos","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Oklahoma (N.A.M., A.L.O.S., F.S.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Neurology, Dell Medical School, University of Texas at Austin (M.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9484-4698","authenticated-orcid":true,"given":"Daniel M.","family":"Mandel","sequence":"additional","affiliation":[{"name":"Department of Neurology, Brown Medical School, Providence, RI (L.S., D.M.M., S.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3594-2159","authenticated-orcid":true,"given":"Mirjam R.","family":"Heldner","sequence":"additional","affiliation":[{"name":"Department of Neurology, Inselspital, University of Bern, Switzerland (M.R.H., M. Arnold)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2646-7300","authenticated-orcid":true,"given":"Vasco","family":"Barata","sequence":"additional","affiliation":[{"name":"Department of Neurology, Centro Hospitalar e Universit\u00e1rio de Coimbra, Unidade Local de Sa\u00fade de Coimbra, Portugal (J.A.S., V.B., S.B.-C., J.S.-F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Bernardo-Castro","sequence":"additional","affiliation":[{"name":"Department of Neurology, Centro Hospitalar e Universit\u00e1rio de Coimbra, Unidade Local de Sa\u00fade de Coimbra, Portugal (J.A.S., V.B., S.B.-C., J.S.-F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3883-5623","authenticated-orcid":true,"given":"Nils","family":"Henninger","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Massachusetts Chan Medical School, Worcester (N.H., J.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3659-5862","authenticated-orcid":true,"given":"Jayachandra","family":"Muppa","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Massachusetts Chan Medical School, Worcester (N.H., J.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4274-4644","authenticated-orcid":true,"given":"Marcel","family":"Arnold","sequence":"additional","affiliation":[{"name":"Department of Neurology, Inselspital, University of Bern, Switzerland (M.R.H., M. Arnold)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Nehme","sequence":"additional","affiliation":[{"name":"Service de Neurologie, CHU Caen Normandie, Universit\u00e9 Caen Normandie, France (A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8480-8220","authenticated-orcid":true,"given":"Aaron","family":"Rothstein","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Pennsylvania, Philadelphia (A.R., O.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8308-6596","authenticated-orcid":true,"given":"Ossama","family":"Khazaal","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Pennsylvania, Philadelphia (A.R., O.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7744-2796","authenticated-orcid":true,"given":"Josefin E.","family":"Kaufmann","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Department of Geriatric Medicine FELIX PLATTER, Department of Clinical Research, University of Basel, Switzerland (J.E.K., S.T.E., C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3855-6234","authenticated-orcid":true,"given":"Stefan T.","family":"Engelter","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Department of Geriatric Medicine FELIX PLATTER, Department of Clinical Research, University of Basel, Switzerland (J.E.K., S.T.E., C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Traenka","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Department of Geriatric Medicine FELIX PLATTER, Department of Clinical Research, University of Basel, Switzerland (J.E.K., S.T.E., C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9902-7528","authenticated-orcid":true,"given":"Issa","family":"Metanis","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel (I.M., R.R.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4794-0334","authenticated-orcid":true,"given":"Ronen R.","family":"Leker","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel (I.M., R.R.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5577-1775","authenticated-orcid":true,"given":"Christian H.","family":"Nolte","sequence":"additional","affiliation":[{"name":"Department of Neurology With Experimental Neurology (C.H.N.), Charite\u2013Universit\u00e4tsmedizin Berlin, Germany."},{"name":"Center for Stroke Research Berlin (C.H.N.), Charite\u2013Universit\u00e4tsmedizin Berlin, Germany."},{"name":"Berlin Institute of Health (C.H.N.), Charite\u2013Universit\u00e4tsmedizin Berlin, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2350-284X","authenticated-orcid":true,"given":"Malik","family":"Ghannam","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa (M.G., E.A.S., M. 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