Introduction Rescue treatment with two simultaneous stent-retrievers (SR) achieves good results in patients with acute ischemic stroke (AIS) and clots refractory to mechanical thrombectomy with single devices; however, the feasibility of this technique as a first-line treatment remains to be determined.

Aim of Study To test the hypothesis that the use of double SR as a first-line technique in AIS has a high first-pass effect (FPE) rate without a significant increase in procedural complications.

Methods The Bifurcation Elective Thrombectomy with double Y Stentretriever (BETYS) registry is an ongoing observational, prospective, multicenter study. Patients fulfilling the inclusion criteria (AIS with carotid T or M1 MCA bifurcation occlusion, ASPECTS≥6, pre-stroke mRS≤2 and first pass with double Aperio Hybrid) will be included in the study. Patients will be followed up to 3 months. Sample size estimated is 150 patients. Aperio Hybrid offers competitive advantages for combined use, featuring a hybrid cell design, with open and closed cell components, and a 4.5x30 mm SR deployable by low-profile microcatheters.

Results The primary efficacy outcome is the rate of FPE. The primary safety outcome is the rate of symptomatic intracranial hemorrhage. Secondary outcomes include functional independence at 3 months. Both the disposition of the SRs (‘Y’, distal SR in different branches, or ‘parallel’, distal SR in the same branch), and its deployment (simultaneous or sequential) will be studied.

Conclusion The BETYS registry is an ongoing prospective study regarding the use of double SR as first-line treatment in anterior circulation large vessel occlusions.

Disclosure of Interest Nothing to disclose.