Background Among acute vertebrobasilar artery occlusion (VBAO) patients, successful reperfusion is a strong predictor of favorable outcomes. However, failed reperfusion (FR) with endovascular thrombectomy (EVT) in VBAO was observed to occur in 18–50% of cases. We aim to evaluate the safety and efficacy of rescue stenting (RS) for VBAO after failed EVT.
Methods Patients with VBAO who received EVT were enrolled retrospectively. Propensity score matching was performed as the primary analysis to compare the outcomes between patients with RS and FR. Furthermore, a comparison between using the self-expanding stent (SES) and balloon-mounted stent (BMS) in the RS group was also conducted. The primary and secondary outcomes were defined as a 90-day modified Rankin Scale (mRS) score 0–3, and a 90-day mRS score 0–2, respectively. Safety outcomes included all-cause mortality at 90 days and symptomatic intracranial hemorrhage (sICH).
Results The RS group showed a significantly higher rate of 90-day mRS score 0–3 (46.6% vs 20.7%; adjusted OR (aOR) 5.06, 95% CI 1.88 to 13.59, P=0.001) and a lower rate of 90-day mortality (34.5% vs 55.2%; aOR 0.42, 95% CI 0.23 to 0.90, P=0.026) than the FR group. The rates of 90-day mRS score 0–2 and sICH were not significantly different between the RS group and FR group. There were no differences in all outcomes between SES and BMS groups.
Conclusions RS appeared to be a safe and effective rescue approach in patients with VBAO who failed EVT, and there was no difference between using SES and BMS.
Data availability statement
Data are available upon reasonable request.
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YL and ZW contributed equally.
Contributors The study was conceived by YL, ZW, JY, and WS. YL prepared the initial draft of the manuscript. YL and ZW carried out the statistical analysis. ZW, JY, and WS revised the manuscript. YL and WS are the guarantors. All authors participated in the data collection, analysis, and interpretation. The final version of the manuscript was approved by all authors.
Funding The study was supported by grants from Key Research and Development Plan Projects of Anhui Province No 202104j07020049 and the Science and Technology Innovation Program of Hunan Province No 2020SK53008.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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