Journal article
Proximal Internal Carotid artery Acute Stroke Secondary to tandem Occlusions (PICASSO) international survey
Journal of neurointerventional surgery, Vol.13(12), pp.1106-1110
12/15/2020
DOI: 10.1136/neurintsurg-2020-017025
PMID: 33323501
Abstract
BackgroundWhile mechanical thrombectomy (MT) is the standard of care for large vessel occlusion strokes, the optimal management of tandem occlusions (TO) remains uncertain. We aimed to determine the current practice patterns among stroke physicians involved in the treatment of TO during MT.MethodsWe distributed an online survey to neurovascular practitioners (stroke neurologists, neurointerventionalists, neurosurgeons, and radiologists), members of professional societies. After 2 months the site was closed and data were extracted and analyzed. We divided respondents into acute stenting and delayed treatment groups and responses were compared between the two groups.ResultsWe received 220 responses from North America (48%), Latin America (28%), Asia (15%), Europe (5%), and Africa (4%). Preferred timing for cervical revascularization varied among respondents; 51% preferred treatment in a subsequent procedure during the same hospitalization whereas 39% preferred to treat during MT. Angioplasty and stenting (41%) was the preferred technique, followed by balloon angioplasty and local aspiration (38%). The risk of intracerebral hemorrhage was the most compelling reason for not stenting acutely (68%). There were no significant differences among practice characteristics and timing groups. Most practitioners (70%) agreed that there is equipoise regarding the optimal endovascular treatment of cervical lesions in TO; hence, 77% would participate in a randomized controlled trial.ConclusionsThe PICASSO survey demonstrates multiple areas of uncertainty regarding the medical and endovascular management of TOs. Experts acknowledged the need for further evidence and their willingness to participate in a randomized controlled trial to evaluate the best treatment for the cervical TO lesion.
Details
- Title: Subtitle
- Proximal Internal Carotid artery Acute Stroke Secondary to tandem Occlusions (PICASSO) international survey
- Creators
- Cynthia B Zevallos - University of IowaMudassir Farooqui - University of Iowa Hospitals and ClinicsDarko Quispe-Orozco - University of IowaAlan Mendez-Ruiz - University of IowaMary Patterson - St Vincent HospitalKristine Below - St Vincent HospitalSheila O Martins - Neurology, Universidade Federal do Rio Grande do Sul, Porto Alegre, BrazilOssama Y Mansour - Alexandria UniversityFrancisco Mont’Alverne - Hospital Geral de FortalezaThanh N Nguyen - Boston UniversityLuis Lemme - Interventional Neuroradiology, Centro Endovascular Neurologico Buenos Aires, Buenos Aires, Argentina.Adnan H Siddiqui - Neurosurgery and Radiology and Canon Stroke and Vascular Research CenterJustin F Fraser - University of KentuckyAshutosh P Jadhav - University of PittsburghOsama O Zaidat - Neuroscience, St Vincent Mercy Hospital, Toledo, Indiana, USA.Santiago Ortega-Gutierrez - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of neurointerventional surgery, Vol.13(12), pp.1106-1110
- DOI
- 10.1136/neurintsurg-2020-017025
- PMID
- 33323501
- NLM abbreviation
- J Neurointerv Surg
- ISSN
- 1759-8478
- eISSN
- 1759-8486
- Publisher
- BMJ Publishing Group Ltd
- Language
- English
- Date published
- 12/15/2020
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984302200502771
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