Purpose To evaluate clinical and radiologic outcomes of primary intracranial stenting for refractory re-occlusion during stent-based mechanical thrombectomy for acute ischemic stroke intervention.

Method From January 2011 through September 2015, A retrospective study was performed in 27 patients who had hyperacute ischemic stroke and were treated by primary intracranial stenting for refractory re-occlusion during stent-based mechanical thrombectomy. We studied radiologic appearance, clinical presentation and follow up outcomes.

Result Of the 27 patients, 11 patients (40%) showed radiologic and clinical improvement, 5 patients (18%) showed clinical improvement with in-stent stenosis, 6 patients (22%) had complication with hemorrhagic transformation and 4 patients (14%) failed recanalization or severe stenosis. In all cases, we use Solitaire FR stent. 6 patients (22%) were TICI grade III, 10 patients (37%) were TICI grade IIb, 4 patients (14%) were TICI grade IIa, and 4 patients (14%) were TICI grade I. After 3 months, 15 patients (55%) were below mRS 3 points and after 6 month, 18 patients (67%) were below mRS 3 points.

Conclusions These results indicate that primary intracranial stenting for refractory re-occlusion during stent-based mechanical thrombectomy treatment in acute ischemic stroke is effective technique. Further studies are needed to evaluate long-term occlusion and in-stent stenosis.

Disclosures S. Sheen: None. J. Shin: None.