Abstract
Abstract DP342: Rescue versus First-Line Intracranial Stenting during Thrombectomy for Acute Ischemic Stroke: A Propensity-Weighted Analysis of the RESISTANT Registry
Stroke (1970), Vol.57(Suppl_1), DP342
02/2026
DOI: 10.1161/str.57.suppl_1.DP342
Abstract
Introduction: Rescue stenting (RS) is a recognized bailout strategy following failed endovascular thrombectomy (EVT) for acute ischemic stroke (AIS). First-line stenting (FLS) has emerged as a potential alternative to avoid vascular injury and improve outcomes. However, direct comparisons between these strategies remain limited.
Methods: We conducted a comparative analysis of FLS and RS using data from the RESISTANT registry, an international, multicenter, retrospective cohort of AIS patients who received intracranial stenting during EVT from 2016 to 2023. Patients were categorized by stenting strategy: FLS (stent placed without prior thrombectomy) or RS (stent placed after failed thrombectomy). The primary effectiveness outcome was functional independence (modified Rankin Scale [mRS] 0-2) at 90 days. The primary safety outcome was symptomatic intracranial hemorrhage (sICH). Propensity score inverse probability of treatment weighting (IPTW) was used to adjust for baseline differences.
Results: Among 827 patients, 723 were in the RS cohort and 104 in the FLS cohort. Compared to RS, FLS patients more often had diabetes (46.2% vs. 35.2%, p=0.03), prior stroke (46.2% vs. 25.3%, p<0.001), prior antiplatelet use (50.0% vs. 27.7%, p<0.001), and known ICAS (28.8% vs. 6.0%, p<0.001). They also had lower baseline NIHSS scores at presentation (median 8 vs. 14, p<0.001) and shorter onset-to-recanalization times (median 363 vs. 392 min, p=0.006). After IPTW adjustment, functional independence was similar between groups (OR=0.64; 95% CI 0.38-1.07), as was the risk of sICH (OR=0.93; 95% CI 0.34-2.59). No significant differences were observed in secondary outcomes including successful reperfusion, mortality, or procedural complications. Outcomes were similar in both the anterior circulation subgrou (n=589; functional independence: OR=0.62; 95% CI 0.60-1.25; sICH: OR=0.81; 95% CI 0.30-2.18) and the posterior circulation subgroup (n=234; functional independence: OR=0.82; 95% CI 0.32-2.10; sICH: OR=0.81; 95% CI 0.30-2.18).
Conclusion: FLS and RS strategies during EVT for AIS demonstrated comparable safety and efficacy. Prospective, randomized trials are needed to better define optimal treatment approaches.
Details
- Title: Subtitle
- Abstract DP342: Rescue versus First-Line Intracranial Stenting during Thrombectomy for Acute Ischemic Stroke: A Propensity-Weighted Analysis of the RESISTANT Registry
- Creators
- Aaron Rodriguez Calienes - University of MiamiDileep Yavagal - University of MiamiMarta Gadea - Vall d'Hebron Hospital UniversitariJude Charles - Florida Cancer CareFrancesco Diana - Vall d'Hebron Hospital UniversitariJohannes Kaesmacher - University Hospital of BernAdnan Mujanovic - University Hospital of Bernserdar geyik - Istanbul Aydın UniversitySONGUL Senadim - Istanbul Aydın UniversityAmedeo Cervo - Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano NiguardaAndrea Salcuni - Sapienza University of RomeMariangela Piano - Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano NiguardaManuel Moreu - Hospital Clínico San CarlosAlfonso Lopez-Frias - Hospital Clínico San CarlosAmeer Hassan - The University of Texas Rio Grande ValleySamantha Miller - Valley Baptist Medical CenterElena Zapata-Arriaza - Hospital Universitario Virgen del RocíoAsier de Alboniga-Chindurza - Hospital Universitario Virgen del RocíoMauro Bergui - 5T Torino (Italy)Stefano Molinaro - Azienda Ospedaliera Citta' della Salute e della Scienza di TorinoJoao Andre Sousa - University of CoimbraFábio Gomes - University of CoimbraJOAO Freitas - Hospitais da Universidade de CoimbraAndrea Alexandre - Agostino Gemelli University PolyclinicAlessandro Pedicelli - University of CoimbraJeremy Hofmeister - University Hospital of GenevaPaolo Machi - University Hospital of GenevaLuca Scarcia - Hôpitaux Universitaires Henri-MondorErwah Kalsoum - Hôpitaux Universitaires Henri-MondorJose Amorim - Hospital BragaFabiano Cavalcante - Amsterdam University Medical CentersSantiago Ortega-Gutierrez - University of IowaLeonardo Cruz-Criollo - University of IowaLeonardo Renieri - Azienda Ospedaliero-Universitaria CareggiFrancesco Capasso - Azienda Ospedaliero-Universitaria CareggiDaniele G. Romano - Ospedali Riuniti San Giovanni di Dio e Ruggi d'AragonaEduardo Barcena - Hospital Universitario 12 De OctubreDavid Seoane - Ospedali Riuniti San Giovanni di Dio e Ruggi d'AragonaMohamad Abdalkader - Boston Medical CenterPiers Klein - Boston Medical CenterThanh Nguyen - Boston Medical CenterCatarina Perry Da Camara - Unidade Local de Saúde de São JoséIsabel Fragata - Rua Dr Augusto Jose da Cunha, Alges, PortugalJosé Rodríguez Castro - Hospital Universitario Central de AsturiasPEDRO Vega - Hospital Universitario Central de AsturiasAtilla Ozcan Ozdemir - Eskişehir Osmangazi UniversityZehra Uysal Kocabas - Eskişehir Osmangazi UniversityMariano Velo - University of MessinaJoaquín Zamarro Parra - Hospital Universitario Virgen de la ArrixacaGonzalo de Paco - Hospital Universitario Virgen de la ArrixacaYazan Ashouri - Bon Secours Mercy Healthmohammad almajali - Bon Secours Mercy HealthJuan Arenillas - Hospital Clínico Universitario de ValladolidAlicia Sierra-Gomez - Fundación Marques de ValdecillaMichele Romoli - Hospital Clínico Universitario de ValladolidJoao Pedro Marto - Hospital de Egas MonizShadi Yaghi - Hackensack Meridian HealthMarc Ribo - Vall d'Hebron Hospital Universitarialejandro tomasello - Vall d'Hebron Hospital UniversitariManuel Requena - Hospital Valle del Nalón
- Resource Type
- Abstract
- Publication Details
- Stroke (1970), Vol.57(Suppl_1), DP342
- DOI
- 10.1161/str.57.suppl_1.DP342
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Publisher
- Lippincott Williams & Wilkins; PHILADELPHIA
- Language
- English
- Date published
- 02/2026
- Academic Unit
- Neurology; Radiology; Neurosurgery
- Record Identifier
- 9985132181902771
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