Abstract Number: Esoc2026lt83 Emergent Carotid Stenting in Tandem Occlusions With Exracranial Dissection: the Multicenter Ceres-tandem Study
Year: 2026
Type: conference-abstract
Abstract: Background and aims Within the international CERES-TANDEM cohort, emergent carotid stenting (eCAS) during thrombectomy improved 90-day outcomes for anterior circulation tandem lesions overall. Whether this benefit extends to the subgroup with cervical carotid dissection remains uncertain. Methods This is a predefined CERES-TANDEM substudy including consecutive patients with extracranial carotid dissection–related tandem occlusions treated with endovascular thrombectomy at 49 comprehensive stroke centres worldwide (2018–2024). Patients were classified as eCAS (n=288) or no-stenting (n=194); IPTW balanced >20 baseline and procedural covariates, and the primary estimand was 90-day mRS shift. Secondary outcomes were good functional outcome (mRS 0–2), mortality, and safety; we also provide a meta-analysis of eCAS in dissection-related tandem occlusions, including multicentre studies with n>100 patients. Results Patients were middle-aged (median 55 years) with severe stroke at baseline (NIHSS 15–17) and similar imaging profiles across strategies. After IPTW, eCAS was associated with a non-significant trend toward lower disability (common OR 1.10, 95% CI 0.80–1.51) and no excess in sICH or mortality versus no-stenting. Distribution of 90-day mRS suggested numerically more favourable outcomes with eCAS, but good outcome did not differ significantly between strategies. In the updated meta-analysis (3 studies, 892 patients), eCAS yielded a marginal increase in good functional outcome (pooled OR 1.20, 95% CI 0.92–1.57). Conclusions In this CERES-TANDEM substudy, eCAS in cervical dissection–related tandem lesions conferred only a non-significant benefit on functional outcome after rigorous adjustment. Pooled evidence from our meta-analysis suggests a modest treatment effect that supports RCTs. Conflict of interest
Source: European Stroke Journal
Authors: Michele Romoli, Carlos A Molina, Diana Aguiar de Sousa, Elena Zapata Arriaza, Vinay Jaikumar, Jessica Jesser, Mirjam Heldner, Giovanni Merlino, Francesco Arba, Fabrizio Giammello, Razvan Alexandru Radu, Andrea Zini, Luca Scarcia, Lucio D'anna, João André Sousa, Aristeidis Katsanos, Espen Saxhaug Kristoffersen, Alejandro Tomasello, Thanh N Nguyen, Francesco Diana
Institutions: Ospedale “M. Bufalini” di Cesena, Vall d'Hebron Hospital Universitari, University of Lisbon, Hospital Universitario Virgen del Rocío, University at Buffalo, State University of New York, Heidelberg University, University Hospital of Bern, University of Udine, Azienda Ospedaliero-Universitaria Careggi, Réseau hospitalier neuchâtelois, Centre Hospitalier Universitaire de Montpellier, Istituto delle Scienze Neurologiche di Bologna, Centre Hospitalier Universitaire Henri-Mondor, Hôpitaux Universitaires Henri-Mondor, Imperial College London, Unidade Local de Saúde de Coimbra, McMaster University, University of Oslo, Boston Medical Center
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,400
OpenAlex ID: W7160443635
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