{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T07:19:14Z","timestamp":1785568754589,"version":"3.56.0"},"reference-count":34,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2025,4,13]],"date-time":"2025-04-13T00:00:00Z","timestamp":1744502400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,4,13]],"date-time":"2025-04-13T00:00:00Z","timestamp":1744502400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Graham-Dixon charity."}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Tandem occlusions, involving simultaneous extracranial and intracranial artery blockages, represent a complex subtype of acute ischemic stroke treated with mechanical thrombectomy (MT). However, to date, the impact of atrial fibrillation (AF) on outcomes in this population remains unclear. This study aimed to evaluate the safety and efficacy of MT in patients with tandem occlusions, comparing those with AF to their counterparts without AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a multicentre, retrospective study using inverse probability weighting (IPW) to evaluate the effect of AF on outcomes in tandem occlusion patients treated with MT across three comprehensive stroke centers. The primary outcome was functional independence at 90\u2009days (modified Rankin Scale [mRS] 0\u20132). Secondary outcomes included recanalization success (Treatment in Cerebral Infarction (TICI)\u2009\u2a7e\u20092b), intracranial hemorrhage (ICH), symptomatic ICH (sICH), and 90-day mortality. Subgroup analyses assessed the interaction between AF and clinical or procedural factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 635 patients, 164 (25.8%) had AF (Tandem\n                      <jats:sub>AF<\/jats:sub>\n                      ). Tandem\n                      <jats:sub>AF<\/jats:sub>\n                      patients had significantly lower rates of favorable 90-day functional outcomes (adjusted risk ratio [aRR]\u2009=\u20090.49; 95% confidence interval (CI): 0.31\u20130.76; p\u2009=\u20090.001) and higher 90-day mortality (aRR 2.29; 95% CI: 1.47\u20133.55; p\u2009&lt;\u20090.001) compared to non-AF patients. Rates of successful recanalization, ICH, and sICH were similar between groups. Subgroup analysis revealed worse outcomes for Tandem\n                      <jats:sub>AF<\/jats:sub>\n                      patients aged \u2a7e65\u2009years, with National Institute of Health Stroke Scale (NIHSS) 11\u201342, and those treated with general anesthesia or intravenous thrombolysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Patients with tandem occlusion and AF undergoing MT showed significantly worse functional and survival outcomes relative to their non-AF counterparts, despite comparable procedural success rates. These findings highlight the critical need for tailored management strategies to mitigate the unique risks associated with AF in this population. Further research is essential to refine therapeutic approaches and improve outcomes for this high-risk group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17474930251330139","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T02:55:27Z","timestamp":1741920927000},"page":"987-998","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of atrial fibrillation on outcomes in stroke patients with tandem occlusions treated with thrombectomy: A multicentre study"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4349-3322","authenticated-orcid":false,"given":"Lucio","family":"D\u2019Anna","sequence":"first","affiliation":[{"name":"Department of Stroke and Neuroscience, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK"},{"name":"Department of Brain Sciences, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0321-7155","authenticated-orcid":false,"given":"Matteo","family":"Foschi","sequence":"additional","affiliation":[{"name":"Department of Biotechnological and Applied Clinical Sciences, University of L\u2019Aquila, L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariarosaria","family":"Valente","sequence":"additional","affiliation":[{"name":"Clinical Neurology, Department of Medicine, Udine University Hospital, University of Udine, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liqun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, City St George\u2019s, University of London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Mansoor","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, City St George\u2019s, University of London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Fallon","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, City St George\u2019s, University of London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelaida","family":"Gartner Jaramillo","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, City St George\u2019s, University of London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fedra","family":"Kuris","sequence":"additional","affiliation":[{"name":"Clinical Neurology, Department of Medicine, Udine University Hospital, University of Udine, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Taglialatela","sequence":"additional","affiliation":[{"name":"Clinical Neurology, Department of Medicine, Udine University Hospital, University of Udine, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Toraldo","sequence":"additional","affiliation":[{"name":"Clinical Neurology, Department of Medicine, Udine University Hospital, University of Udine, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6686-2696","authenticated-orcid":false,"given":"Filippo","family":"Komauli","sequence":"additional","affiliation":[{"name":"Clinical Neurology, Department of Medicine, Udine University Hospital, University of Udine, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Sponza","sequence":"additional","affiliation":[{"name":"Neuroradiology, Udine University Hospital, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Gavrilovic","sequence":"additional","affiliation":[{"name":"Vascular and Interventional Radiology, Udine University Hospital, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5093-9751","authenticated-orcid":false,"given":"Kyriakos","family":"Lobotesis","sequence":"additional","affiliation":[{"name":"Neuroradiology, Department of Imaging, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Luigi","family":"Gigli","sequence":"additional","affiliation":[{"name":"Clinical Neurology, Department of Medicine, Udine University Hospital, University of Udine, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soma","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Department of Stroke and Neuroscience, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK"},{"name":"Department of Brain Sciences, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Merlino","sequence":"additional","affiliation":[{"name":"Stroke Unit, Udine University Hospital, Udine, Italy"},{"name":"Clinical Neurology, Udine University Hospital, Udine, Italy"},{"name":"DAME, University of Udine, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,13]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000160007.57787.4c"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000237070.80133.1d"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.021893"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.0736"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000211"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.023758"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1105575"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000665"},{"key":"e_1_3_2_10_2","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.124.034783","article-title":"Safety and outcomes of mechanical thrombectomy in acute ischemic stroke attributable to cardiological diseases: a scoping review","volume":"13","author":"D\u2019Anna L","year":"2024","unstructured":"D\u2019Anna L, Abu-Rumeileh S, Merlino G, et al. Safety and outcomes of mechanical thrombectomy in acute ischemic stroke attributable to cardiological diseases: a scoping review. J Am Heart Assoc 2024; 13: e034783.","journal-title":"J Am Heart Assoc"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.124.034861"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.49993"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/2396987320923447"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.031733"},{"key":"e_1_3_2_15_2","article-title":"Hub-and-spoke model for thrombectomy service in UK NHS practice","volume":"21","author":"Zhang L","year":"2021","unstructured":"Zhang L, Ogungbemi A, Trippier S, et al. Hub-and-spoke model for thrombectomy service in UK NHS practice. Clin Med (Lond) 2021; 21: e26\u2013e31.","journal-title":"Clin Med (Lond)"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-022-02731-4"},{"key":"e_1_3_2_17_2","first-page":"1","article-title":"Comparison of drip-and-ship versus mothership delivery models of mechanical thrombectomy delivery","volume":"3","author":"D\u2019Anna L","year":"2023","unstructured":"D\u2019Anna L, Dolkar T, Vittay O, et al. Comparison of drip-and-ship versus mothership delivery models of mechanical thrombectomy delivery. Stroke Vasc Interv Neurol 2023; 3: 1\u20139.","journal-title":"Stroke Vasc Interv Neurol"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/2396987321989865"},{"key":"e_1_3_2_19_2","first-page":"1534","article-title":"Use of the Alberta stroke program early CT score (ASPECTS) for assessing CT scans in patients with acute stroke","volume":"22","author":"Pexman JH","year":"2001","unstructured":"Pexman JH, Barber PA, Hill MD, et al. Use of the Alberta stroke program early CT score (ASPECTS) for assessing CT scans in patients with acute stroke. AJNR Am J Neuroradiol 2001; 22: 1534\u20131542.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.010049"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1214\/09-STS313"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1411587"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414905"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1415061"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414792"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1503780"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2016-314117"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2024.05.120"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-023-03649-x"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12094"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.5853\/jos.2023.00759"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2012.2569"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2017.01.007"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-023-03127-4"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/ijcp.13070"}],"container-title":["International Journal of Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17474930251330139","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17474930251330139","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17474930251330139","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T07:23:44Z","timestamp":1777706624000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17474930251330139"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,13]]},"references-count":34,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1177\/17474930251330139"],"URL":"https:\/\/doi.org\/10.1177\/17474930251330139","relation":{},"ISSN":["1747-4930","1747-4949"],"issn-type":[{"value":"1747-4930","type":"print"},{"value":"1747-4949","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,13]]}}}