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  • Efficacy and safety of rescue stenting following failed mechanical thrombectomy for anterior circulation large vessel occlusion: propensity score analysis

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Ischemic Stroke
Original research
Efficacy and safety of rescue stenting following failed mechanical thrombectomy for anterior circulation large vessel occlusion: propensity score analysis
  1. Feng Peng1,2,
  2. Junfang Wan3,
  3. Wenhua Liu4,
  4. Wenguo Huang5,
  5. Li Wang6,
  6. Tao Qiu7,
  7. Shiquan Yang8,
  8. Qiang Shi7,
  9. Shuai Zhang9,
  10. Guoyong Zeng10,
  11. Yan Wang11,
  12. Zhibin Ai12,
  13. Yong Liu13,
  14. Wei Hu14,
  15. Changming Wen15,
  16. Zhonghua Shi16,
  17. Jie Pu17,
  18. Zhongmin Qiu1,
  19. Deping Wu1,
  20. Zili Gong1,
  21. Jie Shuai1,
  22. Qingwu Yang1,
  23. Wenjie Zi1,
  24. Fengli Li1
  1. 1 Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
  2. 2 Department of Neurology, Zhongshan Hospital Xiamen University, Xiamen, China
  3. 3 Department of Anesthesiology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
  4. 4 Department of Neurology, Wuhan No. 1 Hospital, Wuhan, Hubei, China
  5. 5 Department of Neurology, Maoming Traditional Chinese Medicine Hospital, Maoming, Guangdong, China
  6. 6 Department of Neurology, The Third People’s Hospital of Zigong, Zigong, Sichuan, China
  7. 7 Department of Neurology, The First People’s Hospital of Zigong, Zigong, Sichuan, China
  8. 8 Department of Neurology, The 902th Hospital of The People’s Liberation Army, Bengbu, Anhui, China
  9. 9 Department of Neurology, The First People’s Hospital of Yangzhou, Yangzhou University, Yangzhou, Jiangsu, China
  10. 10 Department of Neurology, Ganzhou People’s Hospital, Ganzhou, Jiangxi, China
  11. 11 Department of Neurology, The Fifth People’s Hospital of Chengdu, Chengdu, Sichuan, China
  12. 12 Department of Neurology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
  13. 13 Department of Neurology, Lu’an Affiliated Hospital of Anhui Medical University, Lu’an, Anhui, China
  14. 14 Department of Neurology, Anhui Provincial Hospital and and The First Affiliated Hospital of USTC, Hefei, Anhui, China
  15. 15 Department of Neurology, Nanyang Central Hospital, Nanyang, Henan, China
  16. 16 Department of Neurosurgey, The 904th Hospital of The People’s Liberation Army, Wuxi, Jiangsu, China
  17. 17 Departmentof Neurology, Ren Min Hospital of Wu Han University, Wuhan, Hubei, China
  1. Correspondence to Dr Fengli Li, Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, China; lifengli01{at}yeah.net

Abstract

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
  • stroke
  • outcome

https://doi.org/10.1136/neurintsurg-2019-015154

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    Footnotes

    • 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.