Neurosurg Rev. 2026 Jun 25;49(1):457. doi: 10.1007/s10143-026-04379-7.
ABSTRACT
INTRODUCTION: The effectiveness and safety of acute intracranial atherosclerotic disease-related large vessel occlusion (ICAD-LVO) stenting are still up for debate. We conducted a comparative analysis between patients who had successful mechanical thrombectomy (MT) and the group that rescue stent placement following MT failure.
METHODS: Our study included 1125 patients who underwent thrombectomy between January 2020 and December 2024 at 2 centres in Zhejiang, China. Among them, the number of ICAD-LVO patient cases was 430, which were divided into the group with MT alone group and the group with rescue stent after failed thrombectomy. The two groups were balanced through the use of propensity score matching. The primary outcome was a modification of the Rankin Scale (mRS) at 90 days, which measured the change in disability. We measured the secondary outcomes of symptomatic intracranial haemorrhage (sICH), 90-day mortality and good functioning and independence (defined as a 90-day mRS score of 0 to 2).
RESULTS: Our results showed no statistical differences between the good 90-day mRS score, sICH incidence, and 90-day mortality between the rescue stent group and the successful MT group. In addition, we found that stent placement after multiple thrombectomies reduced the 90-day good functional prognosis (mRS 0-2), which was statistically significant (aOR, 0.43 [95% CI, 0.22-0.85]; P = 0.02).
CONCLUSIONS: Our study indicates rescue stenting after failed MT can yield outcomes similar to successful MT. In addition, our study showed that good outcome of placing a rescue stent after 1 failed thrombectomy is better than after multiple thrombectomies.
PMID:42347994 | DOI:10.1007/s10143-026-04379-7