Background Questions:

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* 1. Institution Name

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* 2. Country

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* 3. Address

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* 4. Are you involved in diagnosis, treatment decisions, or endovascular approach of tandem lesions?

Background Questions:

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* 5. What is your field of practice?

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* 6. How long have you been practicing? (number of years)

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* 7. In which clinical setting do you practice?

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* 8. Does your Medical Center have any of the following accreditation / capabilities (select all that apply)

Tandem Occlusion Treatment, Triage, and Selection Questions:

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* 9. How often do you perform acute extra-cranial internal carotid artery (ICA) stenting in the context of tandem occlusions and mechanical thrombectomy (MT)?

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* 10. What degree of proximal ICA stenosis do you consider treating in the context of Mechanical Thrombectomy (MT)

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* 11. Would you consider treating patients ONLY with complete extracranial acute ICA tandem occlusions without intracranial tandem occlusions?

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* 12. If you have a tandem intracranial occlusion with 100% complete ipsilateral extracranial carotid occlusion, would you take this patient for MT ?

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* 13. What is the preferred modality for triaging tandem lesions?

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* 14. For late window patients: What is your preferred core infarct volume cut-off for treating tandem lesions with acute stenting in MT

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* 15. For tandem lesions treatment with acute stenting in the context of MT, what is your ASPECTS cut-off value?

Treatment Technique Questions:

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* 16. What would be your preferred timing of carotid revascularization procedure if you encounter an ICA stenosis (high-grade) during endovascular therapy in the setting of acute stroke MT procedure?

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* 17. What endovascular approach do you prefer for treating the extracranial lesion of tandem occlusions in the context of acute MT?

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* 18. What is your preferred endovascular treatment approach for tandem occlusion in the acute setting of MT?

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* 19. In a tandem carotid occlusion where you have achieved <60% stenosis after balloon angioplasty and no re-stenosis is demostrated after 20 minutes, would you:

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* 20. What will be your preferred subsequent approach after angioplasty / aspiration or if you do not perform acute stenting treatment for tandem lesion?

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* 21. If there is a tandem lesion on CTA, when would you load antiplatelet medication(s) 

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* 22. What medication(s) do you prefer to use DURING acute stenting, while performing MT?

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* 23. What medication(s) do you prefer to use AFTER acute stenting once the patient has left the angiosuite?

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* 24. Would you treat patients with tandem lesion that were pretreated with IV rtPA?

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* 25. What would be the most compelling reason why you would decide not to treat tandem lesions with acute stenting in the context of MT?

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* 26. Do you think there is an equipoise of the TREATMENT APPROACH (stenting all the cases vs no stenting) of tandem lesions in the context of MT?

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* 27. Do you think there is an equipoise for the CLINICAL EFFICACY of MT in patients with tandem lesions (MT in tandem lesions that were excluded in trial still superior to best medical management; do we need another RCT of MT vs placebo in tandem lesion)?

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* 28. If there is an interventional RCT for MT patients with intracranial and extracranial ICA occlusion treatment, will you be comfortable randomizing patients to aspiration and/ or angioplasty only + intracranial MT vs acute stenting with or without aspiration and/or angioplasty + MT?

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