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@ARTICLE{Maus:841204,
      author       = {Maus, Volker and Behme, Daniel and Borggrefe, Jan and
                      Kabbasch, Christoph and Seker, Fatih and Hüseyin, Cicek and
                      Barnikol, Utako Birgit and Yeo, Leonard Leong Litt and
                      Brouwer, Patrick and Söderman, Michael and Möhlenbruch,
                      Markus  and Psychogios, Marios Nikos and Liebig, Thomas
                      and Dohmen, Christian and Fink, Gereon Rudolf and Mpotsaris,
                      Anastasios},
      title        = {{C}arotid {A}rtery {S}tenosis {C}ontralateral to {A}cute
                      {T}andem {O}cclusion: {A}n {I}ndependent {P}redictor of
                      {P}oor {C}linical {O}utcome after {M}echanical
                      {T}hrombectomy with {C}oncomitant {C}arotid {A}rtery
                      {S}tenting},
      journal      = {Cerebrovascular diseases},
      volume       = {45},
      number       = {1-2},
      issn         = {1421-9786},
      address      = {Basel},
      publisher    = {Karger},
      reportid     = {FZJ-2017-08297},
      pages        = {10 - 17},
      year         = {2017},
      abstract     = {Background and Purpose: Cerebral ischemic strokes due to
                      extra-/intracranial tandem occlusions (TO) of the anterior
                      circulation are responsible for causing mechanical
                      thrombectomy (MT). The impact of concomitant contralateral
                      carotid stenosis (CCS) upon outcome remains unclear in this
                      stroke subtype. Methods: Retrospective analysis of
                      prospectively collected data of 4 international stroke
                      centers between 2011 and 2017. One hundred ninety-seven
                      consecutive patients with anterior TO were treated with MT
                      and acute carotid artery stenting (CAS). Clinical (including
                      demographics and National Institutes of Health Stroke Scale
                      [NIHSS]), imaging (including angiographic evaluation of CCS)
                      and procedural data were evaluated. Favorable clinical
                      outcome was defined as modified Rankin Scale (mRS) ≤2 at
                      90 days. Results: In 186 out of 197 TO patients
                      preinterventional CT angiography was available for analysis,
                      thereof 49 patients $(26\%)$ presented with CCS. Median
                      admission NIHSS and procedural timings did not differ
                      between groups. Reperfusion was successful in 38 out of 49
                      patients $(78\%)$ vs. 113 out of 148 patients $(76\%)$
                      without CCS. In stark contrast, rate of favorable outcome at
                      90 days differed significantly between groups (22 vs.
                      $44\%;$ p < 0.05). The presence of CCS in TO was associated
                      with an unfavorable clinical outcome independent of age and
                      NIHSS in multivariate logistic regression (p < 0.05). Final
                      infarct volume was significantly larger in CCS patients (100
                      ± 127 vs. 63 ± 77 cm3; p < 0.05). Neither all-cause
                      mortality rates (25 vs. $17\%)$ nor frequency of
                      peri-interventional symptomatic intracranial hemorrhage
                      differed between groups (7 vs. $6\%).$ Conclusion: For
                      patients with anterior TO undergoing MT with concomitant CAS
                      the presence of CCS $>50\%$ is an independent predictor of
                      poor clinical outcome. This most likely cause is due to
                      poorer collateral flow to the affected tissue.},
      cin          = {INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406},
      pnm          = {572 - (Dys-)function and Plasticity (POF3-572)},
      pid          = {G:(DE-HGF)POF3-572},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29208850},
      UT           = {WOS:000429361700003},
      doi          = {10.1159/000484719},
      url          = {https://juser.fz-juelich.de/record/841204},
}