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Abstract 297: Impact of stenting for large vessel occlusion due to intracranial stenosis stratified by reperfusion status prior to stenting: Secondary Analysis of the RESCUE‐ICAS Registry
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Abstract 297: Impact of stenting for large vessel occlusion due to intracranial stenosis stratified by reperfusion status prior to stenting: Secondary Analysis of the RESCUE‐ICAS Registry

S Al Kasab, A De Havenon, A Abu Qdais, E Almallouhi, M Jumaa, V Inoa, F Capasso, M Nahhas, R Starke, I Maier, …
Stroke: vascular and interventional neurology, Vol.4(S1)
11/01/2024
DOI: 10.1161/SVIN.04.suppl_1.297
PMCID: PMC12774120
url
https://doi.org/10.1161/SVIN.04.suppl_1.297View
Published (Version of record) Open Access

Abstract

IntroductionAmong patients with emergent large vessel occlusion due to intracranial stenosis (ICAS‐LVO) with successful reperfusion, whether stenting is superior to mechanical thrombectomy (MT) alone remains unknown.MethodsThis was a pre‐specified analysis of the RESCUE‐ICAS, a multicenter prospective observational cohort study from 25 thrombectomy capable centers in North America, Europe and Asia. In this analysis, patients in the stenting and non‐stenting groups were stratified by reperfusion status to either successful (mTICI 2b‐3) or failed reperfusion (mTICI 0‐2a). The primary outcome was functional independence, defined as a modified Rankin Scale score of 0‐2 at 90 days.Results417 patients were included in the study. 218 were treated with MT alone (170 with successful reperfusion), and 199 with MT plus stenting (89 with successful reperfusion pre‐stenting). There were significant differences in age, diabetes, hyperlipidemia, final reperfusion status, and complications between the groups. In multivariate logistic regression (figure 1), the probability of functional independence was lowest in patients managed with MT alone with failed reperfusion (1.8%, 95% CI ‐1.7‐5.3), followed by MT alone with successful reperfusion (35.8%, 95% CI 27.6‐44.0), followed by MT plus stenting and failed reperfusion prior to stenting (44.0%, 95% CI 33.8‐54.2), followed by MT plus stenting with successful reperfusion prior to stenting (49.4%, 95% CI 38.1‐60.7).ConclusionIn patients with ICAS‐LVO, adjunct stenting is associated with better outcomes compared to MT alone even in patients with succesful reperfusion prior to stenting. This could be explained by the high rate of re‐occlusion post procedure.

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