We report our first experience using the CREDO^® heal stent to manage a subacute stroke due to an intracranial in-stent thrombosis.

After withdrawing his anticoagulation three days ago, a 50-year-old man presented with severe, right-sided hemiparesis and motor aphasia (NIHSS 14). Half a year ago, the patient had similar symptoms due to an occlusion of the M1 segment of the MCA that was treated by rescue stenting after failed mechanical thrombectomy. Initial imaging showed a subacute stroke with a mismatch caused by an in-stent thrombosis in the M1 segment. We performed a mechanical thrombectomy that led to a partial recanalisation. Shortly after, the stent was reoccluded entirely again.

Following the intravenous bolus of Aggrastat and Aspirin, we used the self-expanding CREDO^® heal stent with the NeuroSpeed balloon catheter. This resulted in subtotal recanalisation with residual stenosis left proximally. The M1 segment remained open with sufficient flow in the distal branches on MRI before discharge. The patient improved significantly with remaining hemiplegia of the arm and mild paresis of the foot (NIHSS 4) three months after hospital discharge.

Conclusion This case highlights that re-stenting a recurrent ICAD-related stroke using the CREDO^® heal stent is technically feasible, safe, and may improve clinical outcomes.

Disclosure of Interest Nothing to disclose.