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Stent retriever for Tandem Acute Revascularization Technique (START): a novel technique for the endovascular management of tandem occlusions.

Authors
  • Fageeh, Areej1, 2, 3
  • Zur, Gil1, 3
  • Diouf, Ange1, 3
  • La Russa, Daniel1, 4
  • Drake, Brian1, 2, 3, 4
  • P Dos Santos, Marlise1, 3, 4
  • Caron, Katie1
  • Birch, Nicole1
  • Karwaski, Stephen1
  • Trussler, Laurie1
  • Miller, Elizabeth3, 4, 5
  • Fantaneanu, Tadeu3, 4, 6
  • Varghaei, Parizad3, 6
  • Walker, Gregory1, 7
  • Lesiuk, Howard1, 2, 3, 4
  • Fahed, Robert8, 3, 4, 6
  • 1 Interventional Neuroradiology, Ottawa Hospital, Ottawa, Ontario, Canada. , (Canada)
  • 2 Neurosurgery, Ottawa Hospital, Ottawa, Ontario, Canada. , (Canada)
  • 3 Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. , (Canada)
  • 4 Ottawa Hospital Research Institute (OHRI), Ottawa Hospital, Ottawa, Ontario, Canada. , (Canada)
  • 5 Department of Anesthesia, Ottawa Hospital, Ottawa, Ontario, Canada. , (Canada)
  • 6 Neurology, Ottawa Hospital, Ottawa, Ontario, Canada. , (Canada)
  • 7 Department of Medicine - Division of Neurology, Royal Columbian Hospital, New Westminster, British Columbia, Canada. , (Canada)
  • 8 Interventional Neuroradiology, Ottawa Hospital, Ottawa, Ontario, Canada [email protected]. , (Canada)
Type
Published Article
Journal
Journal of NeuroInterventional Surgery
Publisher
BMJ
Publication Date
Apr 23, 2024
Volume
16
Issue
5
Pages
529–530
Identifiers
DOI: 10.1136/jnis-2023-021011
PMID: 37903560
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Tandem occlusions, characterized by the simultaneous presence of an intracranial large vessel occlusion and extracranial carotid artery stenosis or occlusion,1 pose a unique endovascular challenge.2 3 Typically, the extracranial occlusion is a result of atherosclerotic plaque; however, dissections are also a possible cause. It is currently uncertain whether an intracranial first approach or an extracranial first approach should be employed.4 5 A new technique has been developed which allows for the simultaneous treatment of both the intracranial and the extracranial lesion.6 We describe a variation of this technique: the stent retriever for tandem acute revascularization technique (START), which consists of simultaneously treating the intracranial lesion with stent retriever and contact aspiration, and the extracranial lesion with balloon angioplasty. We present a technical video explaining all the steps of START.(video 1) neurintsurg;16/5/529/V1F1V1Video 1Description and example of the START. © Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.

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