• Liang Ma, Ning Han, Yanzhao Xie, Wentao Yao, Lei Zhao, Kuochang Yin, and Guodong Xu.
• Department of Neurointervention, Hebei General Hospital, Shijiazhuang, China.
• World Neurosurg. 2023 Mar 1; 171: e245e252e245-e252.

BackgroundTandem occlusion accounts for 10%-20% of all large vessel occlusion strokes and often yields a poor recanalization rate. The endovascular treatment of tandem lesions is still controversial. This study uses an endovascular treatment strategy, "guided catheter recovery balloon (GRB)" for the treatment of acute anterior circulation tandem occlusion.MethodsA retrospective design was adopted. The population included patients with acute tandem occlusion who received emergency GRB endovascular treatment. And the choice of stenting was made based on intraoperative radiography imaging. Recanalization was evaluated by the thrombolysis in cerebral infarction score after the operation. Three-month modified Rankin Scale follow-up results were recorded, and modified Rankin Scale ≤2 was considered favorable recovery.ResultsA total of 55 patients aged 66.9 ± 8.5 years were enrolled, 37 of whom received stenting. The mean overall recanalization time was 46 minutes. Fifty (90.9%) patients achieved successful recanalization with a thrombolysis in cerebral infarction score of 2b-3. At the 3-month follow-up, the number of patients with favorable functional recovery was 28 (50.9%). The presence of hypertension was correlated with a favorable recovery outcome: 82.1% of the favorable recovery population had hypertension, and 55.6% of the unfavorable outcome population had hypertension (P = 0.033). There was no statistically significant association between stent application and favorable recovery outcomes (P = 0.504).ConclusionsGRB technique showed a high recanalization rate when applied to the treatment of acute anterior circulation tandem occlusion.Copyright © 2022 Elsevier Inc. All rights reserved.

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