Introduction Thrombectomy is the standard treatment for acute ischemic stroke. No treatment for failed Thrombectomy has been so far established. As a rescue method, a double stent-retriever(SR) seems to be effective and associated with a low complication rate.

Aim of Study To prove the efficacy and saftey of Double Stentreiver as a rescue method after failed Thrombectomy.

Methods In a retrospective analysis, all patients having received mechanical Thrombectomy with double-SR as rescue therapy following failed single-SR thrombectomy between 2010–2022 were studied. The efficacy and safety of double-SR rescue therapy were evaluated using modified thrombolysis in cerebral infarction (TICI 2b/3), European Cooperation Acute Stroke Study( ECASS) II classification, and the National Institutes of Health Stroke Scale Score (NIHSS) at discharge.

Results Of 120 enrolled patients, 74 presented with MCA- (M1= 66, M2= 8), 14 with TICA, and 14 with basilar artery -occlusion. The mean intervention duration before changing the method was 34.51 minutes, and the mean number of failed- passes was 1.98. Fist-pass Effect was achieved in 81 (67%) patients after using Double-SR. The mean time of rescue-thrombectomy was 26.12 (10–150 minutes). Symptomatic intracerebral hemorrhage was observed in 6 patients (5%).

Conclusion Rescue Mechanical thrombectomy using double-SR is associated with a higher rate of successful recanalization, first-pass effect, and relatively low rate of hemorrhagic complications. Further randomized control trials are needed to confirm results and long-term outcomes.

Disclosure of Interest Nothing to disclose.