Tandem occlusions after emergent stenting in acute ischemic stroke: A retrospective cohort study from a comprehensive stroke center's experience (TOESIS study).

ObjectiveIn acute tandem occlusion, emergent stenting has recently become an endovascular treatment option combined with mechanical thrombectomy to achieve recanalization. However, data on the beneficial endovascular management of tandem occlusion in two vascular territories remain limited. The purpose of this study was to compare improvements in clinical outcomes between two vascular territories 3 months after emergent stenting.MethodsThis retrospective cohort study included consecutive patients with acute ischemic stroke who underwent emergent extracranial stenting at our hospital. The primary outcomes were the rate of favorable outcome at 3 months and the incidence of postprocedural hemorrhagic transformation.ResultsPosttreatment outcomes were evaluated in 145 eligible patients who underwent emergent extracranial stenting between December 2020 and June 2025. At 3 months postprocedure, 108 patients (74.5%) had favorable outcomes, of whom 97 (66.9%) achieved good outcomes. Smoking, dyslipidemia, National Institutes of Health Stroke Scale score ≥12, diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography Score ≤6, and procedural complications (p < 0.05) were significantly associated with poor outcomes.ConclusionsIn summary, emergent stenting for tandem occlusions involving both vascular territories appears to be an essential recanalization method associated with improved clinical outcomes at the 3-month follow-up.