Abstract
Abstract TP290: Final Infarct Volume as a Surrogate Endpoint in Anterior-Circulation ICAS-LVO Stroke - Secondary Analysis of the RESCUE-ICAS Registry
Stroke (1970), Vol.57(Suppl_1), TP290
02/2026
DOI: 10.1161/str.57.suppl_1.TP290
Abstract
Introduction: Final infarct volume (FIV) on 24-hour MRI is a well-established imaging biomarker linked to functional recovery after ischemic stroke,1-3 yet its prognostic value in ICAS-LVO remains poorly explored. The impact of adjunct intracranial stenting on both infarct size and infarct progression also remains unclear in this population. This study aimed to examine the association between FIV and clinical outcome, evaluate the effect of adjunct stenting on FIV and infarct progression, and assess the relationship between infarct progression and functional independence.
Methods: We conducted a secondary analysis of the RESCUE-ICAS registry,4 only patients with anterior circulation LVO with MRI after thrombectomy were included. Final infarct volume (FIV) was measured on diffusion-weighted MRI performed 24-36 hours post thrombectomy. Infarct progression was defined as the difference between baseline CTP infarct volume (CBF <30%) on presentation and 24-36-hour FIV. The primary outcome was 90-day functional independence (mRS 0-2). Secondary outcomes included the effect of adjunct stenting on FIV and infarct progression. Associations were analyzed using multivariable logistic regression and inverse probability of treatment weighting (IPTW).
Results: Of the 417 patients included in the RESCUE-ICAS registry, 203 had anterior circulation ICAS-LVO and underwent MRI 24-36 hours post-thrombectomy. Among these, 80 patients (39%) received adjunct stenting. FIV was independently associated with 90-day functional independence (adjusted OR per 10 mL increase: 0.8; 95% CI: 0.68-0.94; p = 0.007). Adjunct stenting was associated with smaller FIV (IPTW-adjusted mean difference: -25.07 mL; 95% CI: -40.36 to -9.78; p = 0.001). In 108 patients with baseline CTP data and FIV data, infarct progression was not significantly different between stented and non-stented groups (Δ -9.53 mL; 95% CI: -37.9 to 18.8; p = 0.506), but progression <44.5 mL was strongly associated with favorable outcome.
Conclusion: Among ICAS-LVO patients, 24-36-hour FIV is a strong predictor of functional outcome. Adjunct stenting is associated with smaller FIV. Lower infarct progression was also associated with favorable outcome. These findings highlight FIV as a reliable imaging biomarker and potential surrogate endpoint in future trials.
Details
- Title: Subtitle
- Abstract TP290: Final Infarct Volume as a Surrogate Endpoint in Anterior-Circulation ICAS-LVO Stroke - Secondary Analysis of the RESCUE-ICAS Registry
- Creators
- Mohamad AbdalKader - Boston UniversityAmeer Hassan - The University of Texas Rio Grande ValleyDavid Altschul - Montefiore Medical CenterJustin Mascitelli - The University of Texas Health Science Center at San AntonioRobert Regenhardt - The University of Texas Health Science Center at HoustonStacey Quintero Wolfe - Wake Forest UniversityMohamad Ezzeldin - Lone Star College KingwoodKaustubh Limaye - Indiana University – Purdue University IndianapolisRobert Starke - University of MiamiHosam Al Jehani - Imam Abdulrahman Bin Faisal UniversityIsabel Fragata - Unidade Local de Saúde de São JoséHafeez Niazi - Drexel UniversityMatthew Bender - University of RochesterNitin Goyal - Semmes Murphey FoundationKrisztina Moldovan - Brown UniversityStavropoula Tjoumakaris - Thomas Jefferson UniversityIlko Maier - Nephrologisches Zentrum GoettingenAli Alawieh - Emory and Henry CollegeJonathan Grossberg - Emory and Henry CollegeMohammed Almekhlafi - University of CalgaryEytan Raz - NYU Langone HealthPascal Jabbour - Thomas Jefferson UniversityMarios Psychogios - University Hospital of BaselAdam Mierzwa - University of ToledoEdgar Samaniego - University of IowaSyed Zaidi - University of ToledoAlejandro Spiotta - Medical University of South CarolinaJan-Karl Burkhardt - University of PennsylvaniaBrian Jankowitz - John F. Kennedy Medical CenterKimberly Kicielinski - Medical University of South CarolinaAshley Choi - Medical University of South CarolinaJonathan Lena - Medical University of South CarolinaZachary Hubbard - Medical University of South CarolinaAhmad Abu Qdais - Medical University of South CarolinaMustafa Ismail - Medical University of South CarolinaOsama Zaidat - Mercy HealthAhmed Abdelwahab - Medical University of South CarolinaColin P Derdeyn - University of Virginia Health SystemRamesh Grandhi - University of UtahEyad Almallouhi - Sarasota Memorial HospitalShadi Yaghi - Brown UniversityThanh Nguyen - Boston UniversityVioliza Inoa - Semmes Murphey FoundationAdam de Havenon - Yale UniversitySami Al Kasab - Medical University of South CarolinaFrancesco Capasso - Azienda Ospedaliero-Universitaria CareggiMichael Nahhas - The University of Texas Health Science Center at HoustonMouhammad Jumaa - ProMedica
- Resource Type
- Abstract
- Publication Details
- Stroke (1970), Vol.57(Suppl_1), TP290
- DOI
- 10.1161/str.57.suppl_1.TP290
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Publisher
- Lippincott Williams & Wilkins; PHILADELPHIA
- Language
- English
- Date published
- 02/2026
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9985132181802771
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