Introduction Thrombectomy case loads are increasing, but complications of thrombectomy are poorly explored. Intracranial vessel perforation is a severe complication of thrombectomy with an incidence of 1-2 per 100 thrombectomies and a 90 day mortality of approximately 50%. Currently it is unclear why few patients experience this complication while the majority of patients does not. Furthermore, no high-quality data exist to guide emergent complication management.

Aim of Study To announce the PeRforation EVents during ENdovascular Therapy for acute ischemic stroke (PREVENT) Registry.

Methods The PREVENT Registry will be a multicenter international prospective and retrospective registry with the following aims:

(1) identification of risk factors associated with vessel perforation during thrombectomy in order to prevent this complication

(2) development of a classification of periprocedural perforations that is easy to use and can aid in the interventionalist’s decision-making immediately after the perforation occurs

(3) comparison of different strategies regarding bleeding control in order to improve complication management

(4) comparison of abortion vs pursuit of thrombectomy after perforation in order to improve the management of the ischemic stroke of patients with vessel perforation

(5) development of a novel, safety-optimized thrombectomy technique

Results Results will be presented once the registry is closed.

Conclusion In order to refine thrombectomy beyond revascularization times, the safety of the procedure needs to be improved. This is especially important since patients with limited therapeutic yield are more and more considered for thrombectomy. The PREVENT registry aims at providing answers to urgent questions about periprocedural vessel perforation, arguably the most serious complication of thrombectomy.