{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:59:38Z","timestamp":1791878378875,"version":"4.3.4"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["SVIN"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Simultaneous multivessel occlusions (MVOs) are a rare condition, which may be encountered during endovascular thrombectomy (EVT) for acute ischemic stroke. This study aimed to investigate the prevalence, associated factors, and outcome of patients with acute ischemic stroke and MVO who underwent EVT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Consecutive patients with acute ischemic stroke who received EVT between September 2014 and April 2021 were included. Acute MVO was defined as simultaneous occlusions of \u22652 intracranial or extracranial major vessels in either bilateral anterior circulation or anterior plus posterior circulation. Patients\u2019 baseline characteristics and outcome of MVO were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Of 602 patients with acute ischemic stroke (mean age, 71\u00b113 years; male, 53.1%) who received EVT, 11 patients (1.8%) had acute MVO. The involved vessels included bilateral internal carotid arteries in 3, bilateral middle cerebral arteries in 4, vertebral artery and distal middle cerebral artery in 1, and internal carotid artery and distal posterior cerebral artery in 3 patients. Preadmission dependence (modified Rankin scale score &gt;2), higher initial stroke severity, and posterior cerebral artery occlusion were more frequently found in MVO. The cause of MVO included large vessel atherosclerosis in 4, cardioembolic in 4, cancer\u2010related hypercoagulability in 2, and postpartum in 1 patient. Several patients had received simultaneous multitargeted EVT, but only 4 of them achieved optimal reperfusion in both vessels. Compared with patients without MVO, those with MVO had higher mortality (adjusted odds ratio, 6.75; 95% CI, 1.93\u201323.6) and poor functional outcome (common odds ratio for 1\u2010point improvement at modified Rankin scale, 0.14, 95% CI, 0.05\u20130.45) at 90 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p xml:lang=\"en\">Acute simultaneous MVO in patients who underwent EVT is a rare yet devastating condition. Multitarget mechanical thrombectomy to achieve reperfusion is challenging but still possible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/svin.121.000228","type":"journal-article","created":{"date-parts":[[2022,4,16]],"date-time":"2022-04-16T08:56:58Z","timestamp":1650099418000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Endovascular Thrombectomy in Patients With Acute Ischemic Stroke With Simultaneous Multivessel Occlusions"],"prefix":"10.1161","volume":"2","author":[{"given":"Chi\u2010Ting","family":"Chung","sequence":"first","affiliation":[{"name":"National Taiwan University Hospital","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1258-8775","authenticated-orcid":false,"given":"Chih\u2010Hao","family":"Chen","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai\u2010Jui","family":"Chu","sequence":"additional","affiliation":[{"name":"En Chu Kong Hospital","place":["New Taipei City, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Ming","family":"Chang","sequence":"additional","affiliation":[{"name":"National Cheng Kung University","place":["Tainan, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pi\u2010Shan","family":"Sung","sequence":"additional","affiliation":[{"name":"National Cheng Kung University","place":["Tainan, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen\u2010Heng","family":"Lin","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung\u2010Wei","family":"Lee","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010Kai","family":"Tsai","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung\u2010Chun","family":"Tang","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiann\u2010Shing","family":"Jeng","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00163-X"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.029629"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","first-page":"1846","DOI":"10.1212\/WNL.58.12.1846","article-title":"Sudden coma from acute bilateral internal carotid artery territory infarction","volume":"58","author":"Kwon SU","year":"2002","unstructured":"Kwon SU, Lee SH, Kim JS. Sudden coma from acute bilateral internal carotid artery territory infarction. Neurology. 2002;58:1846\u20131849.","journal-title":"Neurology"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1159\/000362160"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radcr.2020.01.007"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.2478\/raon-2020-0017"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13760-019-01079-6"},{"key":"e_1_3_2_9_2","first-page":"339","article-title":"Successful reperfusion of bilateral middle cerebral artery embolic occlusions using stent retriever thrombectomy","volume":"31","author":"Miller A","year":"2018","unstructured":"Miller A, Onofrio A, Graybeal D, Mir O, Linebarger MB, Layton KF. Successful reperfusion of bilateral middle cerebral artery embolic occlusions using stent retriever thrombectomy. Proc (Bayl Univ Med Cent). 2018;31:339\u2013341.","journal-title":"Proc (Bayl Univ Med Cent)"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.08.236"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2020-237965"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.021276"},{"key":"e_1_3_2_13_2","doi-asserted-by":"crossref","first-page":"E143","DOI":"10.1093\/ons\/opz230","article-title":"Simultaneous bilateral carotid thrombectomies: a technical note","volume":"18","author":"Larrew T","year":"2020","unstructured":"Larrew T, Hubbard Z, Almallouhi E, Banerjee C, Moss M, Spiotta AM. Simultaneous bilateral carotid thrombectomies: a technical note. Oper Neurosurg (Hagerstown). 2020;18:E143\u2013E148.","journal-title":"Oper Neurosurg (Hagerstown)"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.5797\/jnet.cr.2017-0110"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-013-0746-4"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1080\/20009666.2017.1379854"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpn.2016.07.014"},{"key":"e_1_3_2_18_2","doi-asserted-by":"crossref","first-page":"E149","DOI":"10.1093\/ons\/opz273","article-title":"Commentary: simultaneous bilateral carotid thrombectomies: a technical note","volume":"18","author":"Srivatsan A","year":"2020","unstructured":"Srivatsan A, Kan P. Commentary: simultaneous bilateral carotid thrombectomies: a technical note. Oper Neurosurg (Hagerstown). 2020;18:E149\u2013E150.","journal-title":"Oper Neurosurg (Hagerstown)"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0104862"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000211"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1713973"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.001972"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.010049"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1159\/000514369"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25227"}],"container-title":["Stroke: Vascular and Interventional Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/SVIN.121.000228","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T12:54:11Z","timestamp":1773924851000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/SVIN.121.000228"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5]]},"references-count":24,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1161\/SVIN.121.000228"],"URL":"https:\/\/doi.org\/10.1161\/svin.121.000228","relation":{},"ISSN":["2694-5746"],"issn-type":[{"value":"2694-5746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5]]},"assertion":[{"value":"2021-10-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e000228"}}