Journal article
Balloon-mounted versus self-expandable stent in failed neurothrombectomy: a post hoc analysis of the SAINT study
Journal of neurointerventional surgery, Vol.17(e2), pp.e295-e302
05/2025
DOI: 10.1136/jnis-2024-022795
PMID: 39884852
Abstract
BackgroundPrevious studies have shown that when thrombectomy has failed, rescue intracranial stenting is associated with better clinical outcomes compared with failed reperfusion. However, comparative data regarding stent type are lacking.ObjectiveTo compare the procedural and clinical outcomes of balloon-mounted stents (BMS) with those of self-expandable stents (SES).MethodsRetrospective analysis of a prospectively collected database from the Stenting and Angioplasty in NeuroThrombectomy (SAINT) consortium. Patients were included if thrombectomy had failed and they then underwent rescue emergency stenting. Patients treated with SES or BMS were compared using inverse probability of treatment weighting. The primary outcome was the final reperfusion as measured by the modified Thrombolysis in Cerebral Infarction (mTICI) Scale. Safety measures included rates of symptomatic intracranial hemorrhage, procedural complications, and 90-day mortality.ResultsA total of 328 patients were included. Baseline clinical and procedural characteristics were well balanced among both groups. The BMS group (n=127) had higher rates of successful reperfusion (94.5% vs 86.6%, aOR=4.23, 95% CI 1.57 to 11.37, P=0.004) and increased likelihood of higher degree of final reperfusion on the mTICI Scale (acOR=2.06, 95% CI 1.19 to 3.57, P=0.01) than the SES group (n=201). No difference in modified Rankin Scale shift (acOR=0.98, 95% CI 0.54 to 1.79, P=0.95), rates of mRS0–2 (26% vs 36%, aOR=0.93, 95% CI 0.46 to 1.88, P=0.83) and mRS0–3 (43% vs 50%, aOR=0.92, 95% CI 0.51 to 1.66, P=0.77) at 90 days were noted. Safety measures were comparable in both groups.ConclusionThe present study demonstrates higher reperfusion rates with BMS than with SES in failed thrombectomy procedures that involved rescue stenting. No differences in hemorrhagic complications or clinical outcomes were noted. Further larger controlled studies are warranted.
Details
- Title: Subtitle
- Balloon-mounted versus self-expandable stent in failed neurothrombectomy: a post hoc analysis of the SAINT study
- Creators
- Mahmoud H Mohammaden - Emory UniversityPedro N Martins - Emory UniversityHassan Aboul-Nour - University of KentuckyAlhamza R Al-Bayati - UPMC Health SystemAmeer E Hassan - The University of Texas Rio Grande ValleyWondwossen Tekle - The University of Texas Rio Grande ValleyJohanna T Fifi - Icahn School of Medicine at Mount SinaiShahram Majidi - Icahn School of Medicine at Mount SinaiOkkes Kuybu - Department of Neurology and Neurosurgery, UPMC, Pittsburgh, Pennsylvania, USABradley A Gross - University of PittsburghMichael Lang - University of PittsburghGustavo M Cortez - Baptist Medical Center JacksonvilleRicardo A Hanel - Baptist Medical Center JacksonvilleAmin Aghaebrahim - Baptist Medical Center JacksonvilleEric Sauvageau - Baptist Medical Center JacksonvilleMohamed A Tarek - Emory UniversityMudassir Farooqui - University of IowaSantiago Ortega-Gutierrez - University of Iowa Hospitals and ClinicsCynthia B Zevallos - University of IowaMilagros Galecio-Castillo - University of IowaSunil A Sheth - The University of Texas Health Science Center at HoustonMichael Nahhas - The University of Texas Health Science Center at HoustonSergio Salazar-Marioni - The University of Texas Health Science Center at HoustonThanh N Nguyen - Boston UniversityMohamad Abdalkader - Boston Medical CenterPiers Klein - Boston UniversityMuhammad Hafeez - Baylor SchoolPeter Kan - The University of Texas Medical Branch at GalvestonOmar Tanweer - Baylor SchoolAhmad Khaldi - WellStar Health SystemHanzhou Li - WellStar Health SystemMouhammad Jumaa - University of Toledo Medical CenterSyed F Zaidi - University of Toledo Medical CenterMarion Oliver - University of Toledo Medical CenterMohamed M Salem - Hospital of the University of PennsylvaniaJan-Karl Burkhardt - Hospital of the University of PennsylvaniaBryan Pukenas - Hospital of the University of PennsylvaniaNicholas Vigilante - Cooper University Health CareMary Penckofer - Cooper University Health CareJames E Siegler - Cooper University Health CareSophia Peng - University of Illinois Urbana-ChampaignAli Alaraj - University of Illinois ChicagoJonathan A Grossberg - Grady Health SystemRaul Nogueira - UPMC Health SystemDiogo C Haussen - Emory University
- Resource Type
- Journal article
- Publication Details
- Journal of neurointerventional surgery, Vol.17(e2), pp.e295-e302
- DOI
- 10.1136/jnis-2024-022795
- PMID
- 39884852
- NLM abbreviation
- J Neurointerv Surg
- ISSN
- 1759-8478
- eISSN
- 1759-8486
- Publisher
- BMJ Publishing Group Ltd
- Language
- English
- Electronic publication date
- 01/30/2025
- Date published
- 05/2025
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984780239602771
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