Outcomes of Adjunct Emergent Stenting Versus Mechanical Thrombectomy Alone: The RESCUE-ICAS Registry.
Publication/Presentation Date
2-1-2025
Abstract
BACKGROUND: Underlying intracranial stenosis is the most common cause of failed mechanical thrombectomy in patients with acute ischemic stroke with large vessel occlusion. Adjunct emergent stenting is sometimes performed to improve or maintain reperfusion, despite limited data regarding its safety or efficacy.
METHODS: We conducted a prospective multicenter observational international cohort study. Patients were enrolled between January 2022 and December 2023 at 25 thrombectomy-capable centers in North America, Europe, and Asia. Consecutive patients treated with mechanical thrombectomy were included if they were identified as having underlying intracranial stenosis, defined as 50% to 99% residual stenosis of the target vessel or intraprocedural reocclusion. The primary outcome was functional independence, defined as a modified Rankin Scale score of 0 to 2 at 90 days. After applying inverse probability of treatment weighting based on propensity scores, we compared outcomes among patients who underwent adjunct emergent intracranial stenting (stenting) versus those who received mechanical thrombectomy alone.
RESULTS: A total of 417 patients were included: 218 patients treated with mechanical thrombectomy alone (168 anterior circulation) and 199 with mechanical thrombectomy plus stenting (144 anterior circulation). Patients in the stenting group were less likely to be non-Hispanic White (51.8% versus 62.4%,
CONCLUSIONS: In patients with underlying stenosis who achieved reperfusion with mechanical thrombectomy, adjunct emergent stenting was associated with better functional outcome without a significantly increased risk of symptomatic hemorrhage.
REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05403593.
Volume
56
Issue
2
First Page
390
Last Page
400
ISSN
1524-4628
Published In/Presented At
Al Kasab, S., Almallouhi, E., Jumaa, M., Inoa, V., Capasso, F., Nahhas, M., Starke, R. M., Fragata, I., Bender, M., Moldovan, K., Yaghi, S., Maier, I., Grossberg, J. A., Jabbour, P., Psychogios, M., Samaniego, E. A., Burkhardt, J. K., Jankowitz, B., Abdalkader, M., Hassan, A. E., … de Havenon, A. (2025). Outcomes of Adjunct Emergent Stenting Versus Mechanical Thrombectomy Alone: The RESCUE-ICAS Registry. Stroke, 56(2), 390–400. https://doi.org/10.1161/STROKEAHA.124.049038
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
39576761
Department(s)
Administration and Leadership
Document Type
Article