Purpose To evaluate the effectiveness and safety of rescue stenting (RS) after failed mechanical thrombectomy (MT) for patients with large artery occlusion in the anterior circulation.
Methods Consecutive patients who experienced failed reperfusion and subsequently did or did not undergo RS at 16 comprehensive stroke centers were enrolled from January 2015 to June 2018. Propensity score matching was used to achieve baseline balance between the patient groups. Symptomatic intracranial hemorrhage (sICH) at 48 hours and the modified Rankin Scale scores and mortality at 3 months in the two groups were compared.
Results A total of 90 patients with RS and 117 patients without RS after failed MT were enrolled. Propensity score matching analysis selected 132 matched patients. The good outcome rate was significantly higher in matched patients with RS than in those without RS (36.4% vs 19.7%, p=0.033), whereas the sICH (13.6% vs 21.2%, p=0.251) and mortality (31.9% vs 43.9%, p=0.151) were not significantly different between the groups.
Conclusions RS seems to be an effective safe choice for patients with large vessel occlusion of the anterior circulation who underwent failed MT.
- rescue stenting
- mechanical thrombectomy
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FP and JW contributed equally.
Contributors FP and JFW prepared the draft of the report. WHL, WGH, LW, TQ, SQY, QS, SZ, GYZ, YW, ABZ, YL, WH, CMW, ZHS ,and JP participated in data collection, data analysis, and interpretation. ZMQ, DPW, ZLG, and JS did the statistical analyses. QWY critically revised the report. WJZ and FLL did the study design. All authors participated in patient enrollment and reviewed the report and approved the final version.
Funding The project is supported by Army Military Medical University Clinical Medical Research Talents Training Program - Three Types of Plan (No. 2018XLC3039), Army Military Medical University Clinical Medical Research Talents Training Program (No. 2018XLC1005), Chongqing Major Disease Prevention and Control Technology Research Project (No. 2019ZX001), Army Military Medical University Clinical Medical Research Talents Training Program - Second Class Project, Question (No. 2018XLC2013).
Competing interests None declared.
Ethics approval Ethics committees of the involved centers.
Provenance and peer review Not commissioned; externally peer reviewed.