Effects of Emergent Carotid Stenting Performed before or after Mechanical Thrombectomy in the Endovascular Management of Patients with Tandem Lesions: A Multicenter Retrospective Matched Analysis

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FIGURE.
Ordinal distribution of 90-day mRS scores in patients receiving eCAS-first versus MT-first treatment, after PSM.

Table 1:

Baseline, imaging, and procedural data of the raw population of patients after division for type of endovascular approach

	eCAS-First Approach	MT-First Approach	P Value^{^a}
No. of patients	87	208
Demographics
Women, n/N (%)	27/87 (31%)	61/208 (29%)	.781
Age in years, mean (SD)	65 (14)	64 (14)	.315
Baseline clinical features
Hypertension	51/87 (59%)	113/208 (54%)	.523
Atrial fibrillation, n/N (%)	4/87 (5%)	13/208 (6%)	.785
Diabetes, n/N (%)	8/87 (9%)	36/208 (17%)	.106
Dyslipidemia, n/N (%)	32/87 (37%)	60/208 (29%)	.215
Coronary artery disease, n/N (%)	11/87 (13%)	23/208 (11%)	.692
ICA atherosclerotic lesion, n/N (%)	75/87 (86%)	153/208 (74%)	.022
Previous stroke, n/N (%)	3/87 (3%)	6/208 (3%)	.726
Antiplatelet therapy, n/N (%)	22/87 (25%)	6/208 (30%)	.433
Anticoagulant therapy, n/N (%)	2/87 (2%)	17/208 (8%)	.163
Therapy with statins, n/N (%)	21/80 (26%)	45/208 (22%)	.518
Pre-event mRS score, median (IQR)	0 (0–0)	0 (0−0)	.447
NIHSS score, median (IQR)	16 (11−20)	16 (11−20)	.382
Baseline imaging data and procedural features
Left side	46/87 (53%)	125/208 (60%)	.252
ASPECTS, median (IQR)	8 (7−9)	7 (7−9)	.003
ICA + M1 occlusion, n/N (%)	61/87 (70%)	158/208 (76%)	.295
ICA + M2 occlusion, n/N (%)	26/87 (30%)	50/208 (24%)	.616
IVT, n/N (%)	47/87 (54%)	125/208 (44%)	.107
LA/CS, n/N (%)	64/87 (74%)	96/208 (46%)	<.001

Table 2:

Outcome data of the raw population of patients after division for type of endovascular approach

	eCAS-First Approach	MT-First Approach	P Value^{^a}
No. of patients	87	208
Procedural and postprocedural outcome data
mTICI score 2b-3, n/N (%)	69/87 (79%)	179/208 (86%)	.149
mTICI score 2b, n/N (%)	26/87 (30%)	57/208 (27%)	.666
mTICI score 2c, n/N (%)	14/87 (16%)	46/208 (22%)	.270
mTICI score 3, n/N (%)	29/87 (33%)	76/208 (37%)	.689
GTR time, mean (SD), minutes	89 (45)	77 (52)	.018
New territory embolism, n/N (%)	10/87 (12%)	32/208 (15%)	.383
Intraprocedural dissection, n/N (%)	2/87 (2%)	7/208 (3%)	.627
Early stent thrombosis, n/N (%)	9/87 (10%)	25/208 (12%)	.558
Parenchymal hemorrhage type 2, n/N (%)	2/87 (2%)	14/208 (7%)	.163
Parenchymal hemorrhage type 1, n/N (%)	27/87 (31%)	53/208 (26%)	.389
Clinical outcome data
90-day mRS score, n/N			.149
0	16/86 (19%)	30/207 (15%)
1	23/86 (27%)	42/207 (20%)
2	16/86 (19%)	39/207 (19%)
3	8/86 (9%)	35/207 (17%)
4	5/86 (6%)	29/207 (14%)
5	7/86 (8%)	16/207 (8%)
90-day mRS score = 0−2, n/N	55/86 (64%)	111/207 (54%)	.076
90-day mortality of any cause, n/N	11/86 (13%)	16/207 (8%)	.187

Table 3:

Univariate analysis after PSM of clinical and angiographic outcome measures

	eCAS-First Approach	MT-First Approach	P Value^{^a}
No. of patients	56	56
Procedural outcome data
mTICI score 2b-3, n/N (%)	41/56 (73%)	51/56 (91%)	.025
mTICI score 2b, n/N (%)	10/56 (18%)	17/56 (30%)	.185
mTICI score 2c, n/N (%)	12/56 (21%)	14/56 (25%)	.823
mTICI score 3, n/N (%)	19/56 (34%)	20/56 (36%)	1.000
GTR time, mean (SD), minutes	93 (±50)	72 (±38)	.017
New territory embolism, n/N (%)	8/56 (14%)	9/56 (16%)	1.000
Intraprocedural dissection, n/N (%)	2/56 (4%)	0/56 (0%)	.496
Early stent thrombosis, n/N (%)	8/56 (14%)	7/56 (13%)	1.000
Parenchymal hemorrhage type 2, n/N (%)	2/56 (4%)	3/56 (5%)	1.000
Parenchymal hemorrhage type 1, n/N (%)	21/56 (38%)	13/56 (23%)	.150
Clinical outcome data
90-day mRS score, n/N			.769
0	10/56 (18%)	9/56 (16%)
1	13/56 (23%)	13/56 (23%)
2	9/56 (16%)	12/56 (21%)
3	6/56 (11%)	6/56 (11%)
4	4/56 (7%)	9/56 (16%)
5	5/56 (9%)	3/56 (5%)
90-day mRS score = 0 − 2, n/N	32/56 (57%)	34/56 (60%)	.848
90-day mortality of any cause, n/N	9/56 (16%)	4/56 (7%)	.237