The rescue carotid stenting has recently been an additional treatment followed by mechanical thrombectomy in tandem occlusions of the anterior circulation. Nevertheless, there were few data to date that support this beneficial treatment in Asia. The investigators hypothesized that this treatment related to improvement of clinical outcomes after procedure.

The anterior circulation made commonly up 70-80% of all ischemic strokes. The mechanical thrombectomy is the gold treatment standard in acute ischemic stroke due to large vessel occlusion of anterior circulation. Tandem occlusions are one of the acute lesions relating to the high poor clinical outcome rate. Besides, tandem characteristic is a challenge to perform endovascular therapy and save procedural time in the restoration blood flow to the cerebral artery territory infarction. Many studies demonstrated the roles of rescue carotid stenting with either proximal-to-distal or distal-to-proximal approach in the successful recanalization of tandem occlusions. However, few studies analyzed in detail this beneficial treatment in Asia. Therefore, the investigators conducted this study to assess whether rescue carotid stenting in the tandem occlusions to improve clinical outcomes at 3 months.

Inclusion Criteria:

• Age > 18 years old
• Onset to treatment time < 24 hours
• NIHSS > 5
• DWI-ASPECTS ≥ 5

Exclusion Criteria:

• Premorbid mRS > 2
• Loss to follow-up after discharge