Comparative Analysis of Antegrade and Retrograde Techniques in Tandem Occlusion Management
Overview
This study compares the clinical and angiographic outcomes of antegrade and retrograde endovascular approaches in patients with tandem occlusion.
Background
Tandem occlusion is a critical condition characterized by concurrent extracranial and intracranial arterial occlusion, often leading to poor clinical outcomes. The optimal treatment strategy remains controversial, with varying practices regarding antegrade and retrograde approaches. Understanding the efficacy of these techniques is essential for improving patient management in acute ischemic stroke.
Data Highlights
Outcome
Antegrade
Retrograde
P-value
Successful Reperfusion (mTICI ≥2b)
94.6%
91.9%
N/A
Favorable Functional Outcome (mRS ≤ 2) at 90 days
45.9%
40.5%
0.639
Symptomatic Intracerebral Hemorrhage (sICH)
8.1%
N/A
0.999
Mortality
10.8%
N/A
0.999
Key Findings
The median age of patients was 67 years, with a predominance of males (81.1%).
Hypertension was present in 36.5% of patients.
Successful reperfusion rates were 94.6% for the antegrade group and 91.9% for the retrograde group.
Favorable functional outcomes at 90 days were observed in 45.9% of the antegrade group and 40.5% of the retrograde group (p = 0.639).
Symptomatic intracerebral hemorrhage occurred in 8.1% of patients, with no significant difference between groups (p = 0.999).
Overall mortality was 10.8%, with no significant difference between the two approaches (p = 0.999).
Clinical Implications
The findings suggest that both antegrade and retrograde techniques yield comparable outcomes in terms of reperfusion success and functional recovery. Clinicians may consider operator preference and individual patient anatomy when selecting a procedural approach.
Conclusion
This study indicates no significant advantage of either antegrade or retrograde techniques in managing tandem occlusions.
