Abstract
Abstract A001: When To Rescue: Optimizing The Timing of Intracranial Rescue Procedure During Mechanical Thrombectomy for Large Vessel Occlusion Strokes - A Pooled Analysis of the SVIN Registry
Stroke (1970), Vol.57(Suppl_1), A001
02/2026
DOI: 10.1161/str.57.suppl_1.A001
Abstract
Background: The optimal timing of intracranial angioplasty/stenting during mechanical thrombectomy (MT) for large vessel occlusion strokes (LVOS) remains uncertain. We aimed to determine whether the timing of rescue angioplasty/stenting impacts functional outcomes in LVOS patients undergoing MT.
Methods: We conducted a pooled analysis of the Society of Vascular and Interventional Neurology Registry data from 2010 to 2023. Included patients had a pre-stroke modified Rankin Scale (mRS) ≤2, underwent MT for ICA or MCA-M1/M2 occlusions, and had available 90-day mRS data. Patients who achieved successful reperfusion after a single pass were excluded. Patients were divided into 4 groups: A) multiple passes without angioplasty/stenting regardless of the final recanalization, B) angioplasty/stenting during 1st or 2nd pass, C) angioplasty/stenting during 3rd or 4th pass, and D) angioplasty/stenting after 4th pass. The primary outcome was the shift in disability at 90-days, measured by mRS. Secondary outcomes included functional independence (90-day mRS0-2), symptomatic intracranial hemorrhage (sICH), and 90-day mortality. All outcomes were adjusted for relevant confounders.
Results: Of 9,238 patients, 1,673 met inclusion criteria; multiple passes without angioplasty/stenting (n=1,477), angioplasty/stenting during 1st or 2nd pass (n=112), angioplasty/stenting during 3rd or 4th pass (n=50), and angioplasty/stenting after 4th pass (n=34). Baseline characteristics are shown in the Table. In ordinal shift analysis, early angioplasty/stenting was associated with significantly better functional outcomes compared to no rescue (mRS shift; acOR1.79, 95%CI1.23-2.62, p=0.002, and 90-day mRS0-2; aOR2.06, 95%CI1.31-3.25, p=0.002). There was no difference between angioplasty/stenting during the 3rd or 4th pass (mRS shift; acOR1.14, 95%CI0.67-1.94, p=0.62 and 90-day mRS0-2; aOR1.23, 95%CI0.61-2.46, p=0.57) and multiple passes without angioplasty/stenting. Patients with late rescue after 4th pass have numerically lower rates of functional independence compared to no rescue (mRS shift; acOR1.01, 95%CI0.51-2.00, p=0.98 and 90-day mRS0-2; aOR0.65, 95%CI0.21-2.02, p=0.46) Figure 1. No differences in mortality or sICH were observed across groups Figure 2.
Conclusions: The current analysis suggests that early rescue angioplasty/stenting is associated with improved functional outcomes compared to no rescue or late intervention in LVOS patients undergoing MT. Large prospective studies are warranted.
Details
- Title: Subtitle
- Abstract A001: When To Rescue: Optimizing The Timing of Intracranial Rescue Procedure During Mechanical Thrombectomy for Large Vessel Occlusion Strokes - A Pooled Analysis of the SVIN Registry
- Creators
- Mahmoud Mohammaden - Emory UniversityJaydevsinh Dolia - Emory UniversityJonathan Grossberg - Emory UniversitySunil Sheth - The University of Texas Health Science Center at HoustonJoseph Samaha - The University of Texas Health Science Center at HoustonAnanya Iyyangar - The University of Texas Health Science Center at HoustonHussain Azeem - The University of Texas Health Science Center at HoustonGuilherme Dabus - The Cardiac and Vascular InstituteItalo Linfante - Baptist Hospital of MiamiRobert Wicks - Baptist Hospital of MiamiMalik Fakhar - Baptist Hospital of MiamiLeonardo Cruz-Criollo - University of IowaJorge Cespedes Segura - University of IowaAnderson Brito - University of IowaSantiago Ortega-Gutierrez - University of IowaMouhammad Jumaa - ProMedica Toledo HospitalRichard Burgess - University of ToledoMonica Hajjar - ProMedicaShahram Majidi - Icahn School of Medicine at Mount SinaiFifi Johanna - Icahn School of Medicine at Mount SinaiAmol Mehta - Icahn School of Medicine at Mount SinaiJane Khalife - Cooper University HospitalDanial Chaudhri - Cooper University HospitalArthur Gribachov - Cooper University HospitalThanh Nguyen - Boston Medical CenterMohamad AbdalKader - Boston Medical CenterPiers Klein - Boston Medical CenterAmeer Hassan - The University of Texas Rio Grande ValleyWONDWOSSEN Tekle - Valley Baptist Medical CenterSamantha Miller - Valley Baptist Medical CenterBrijesh Mehta - University of North Carolina at PembrokeJoy Sessa - University of North Carolina at PembrokeWilson Rodriguez - Saint Louis UniversityGuillermo Linares - Saint Louis Universityrebecca sugg - University of South Alabama Medical CenterMuhammad Adeel Saleemi - University of South Alabama Medical CenterRaul Nogueira - University of PittsburghAlhamza Al-Bayati - University of PittsburghMohamed Doheim - University of PittsburghDiogo Haussen - Emory University
- Resource Type
- Abstract
- Publication Details
- Stroke (1970), Vol.57(Suppl_1), A001
- DOI
- 10.1161/str.57.suppl_1.A001
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Publisher
- Lippincott Williams & Wilkins
- Language
- English
- Date published
- 02/2026
- Academic Unit
- Neurology; Radiology; Neurosurgery
- Record Identifier
- 9985132182302771
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