Postulated advantages of each treatment approach for patients with tandem lesions (acute stent placement versus no acute stent placement)
| Potential Advantages of Acute Stent Placement | Potential Advantages of No Acute Stent Placement |
|---|---|
| Treatment of the causative embolic lesion and lower risk of stroke recurrence | Lower risk of intracranial hemorrhage (avoidance of hyperperfusion, acute antiplatelet agents) |
| Improvement of cerebral perfusion with potential attenuation of infarct progression | Lower risk of iatrogenic artery-to-artery embolization during stent deployment |
| Contribution to spontaneous intracranial clot lysis | No risk of in-stent thrombosis |
| Avoids delays in intracranial recanalization (if stent placement before thrombectomy) | |
| Lower risk of procedural bradycardia and hypotension from carotid baroreceptor activation with stent deployment |