Effect of Acute Intracranial Stenting in Patients With Successful Reperfusion Following Large-Vessel Occlusion Secondary to Intracranial Atherosclerosis: Secondary Analyses of the RESCUE-ICAS Study.

Publication/Presentation Date

3-1-2026

Abstract

BACKGROUND: The RESCUE-ICAS study (Registry of Emergent Large-Vessel Occlusion due to Intracranial Stenosis) demonstrated that patients undergoing acute stenting of intracranial atherosclerosis with large-vessel occlusion after mechanical thrombectomy had better outcomes than those undergoing mechanical thrombectomy alone. We present 2 secondary analyses of RESCUE-ICAS to evaluate intracranial stenting among patients who achieved successful reperfusion.

METHODS: From a prospective observational cohort of 25 stroke centers (2022-2023), patients with acute intracranial occlusion, National Institutes of Health Stroke Scale score ≥6, and 50% to 99% residual stenosis or occlusion after endovascular thrombectomy were included. In the first analysis, we compared patients with stenting versus those without stenting from among those patients with a final modified Thrombolysis in Cerebral Infarction score of 2B-3. In the second analysis, we compared patients who underwent stenting with those who did not from among the patients with a Thrombolysis in Cerebral Infarction (TICI) score of 2B-3 before stenting. The odds of a favorable 90-day mRS (0-2) and 24-hour MRI infarct volume < 30 mL were assessed using multivariable logistic regression. We also examined the rates of symptomatic ICH and death at 90 days in these cohorts.

RESULTS: Overall, 351 (84.2%) patients had successful reperfusion, with 181 (51.7%) undergoing stenting. More patients who underwent acute stenting achieved an mRS score of 0 to 2 at 90 days (adjusted odds ratio, 1.88;

CONCLUSIONS: Among both the cohort with final successful reperfusion and the cohort with initial successful reperfusion after mechanical thrombectomy alone, intracranial stenting was associated with better long-term clinical and radiographic outcomes, without higher morbidity and mortality.

REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05403593.

Volume

6

Issue

2

First Page

001841

Last Page

001841

ISSN

2694-5746

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

41815302

Department(s)

Administration and Leadership

Document Type

Article

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