Journal article
Rescue Stenting for Failed Mechanical Thrombectomy in Acute Basilar Artery Occlusions: Analysis of the PC-SEARCH Registry
Stroke (1970), Vol.56(2), pp.401-412
02/2025
DOI: 10.1161/STROKEAHA.124.047694
PMID: 39571537
Abstract
Background: We aimed to investigate whether rescue stenting (RS) following failed mechanical thrombectomy (MT) for acute basilar artery occlusion (BAO) results in superior functional outcomes and enhanced safety compared to the natural history of failed mechanical thrombectomy (MT).
Methods: This retrospective cohort study utilized data from the PC-SEARCH registry, encompassing eight high-volume centers in the United States and covering the period from 2015 to 2021. Patients with BAO who experienced failed MT (mTICI score of 0-2a after at least one attempt of clot retrieval) were categorized based on whether they received additional intervention with RS. The primary outcome was a shift analysis of the 90-day mRS. Multivariable logistic regression was employed to assess both efficacy and safety outcomes.
Results: Of a total of 444 patients, 119 presented failed MT and were included in the analysis. The RS group comprised 65 (14.6%) patients, while the control group consisted of 54 (12.2%) patients. After adjusting, the RS group showed a favorable shift in the overall 90-day mRS distribution (acOR=4.56; 95% CI 1.67-12.45; p=0.003) and higher rates of 90-day 0-3 mRS (RS: 44.6% vs. control: 18.5%, aOR=7.57; 95% CI 1.91-30.12; p = 0.004) compared to the control group. RS also showed lower rates of 90-day mortality (RS: 43.1% vs. control: 64.8%, aOR=0.27; 95% CI 0.09-0.80; p=0.018) and comparable rates of sICH (RS: 3.1% vs. control: 13%, aOR=0.31; 95% CI 0.05-1.95; p=0.214).
Conclusions: Our study demonstrated that RS is associated with improved functional outcomes and reduced mortality in BAO patients presenting MT failure. Further randomized trials are needed to validate these findings.
Details
- Title: Subtitle
- Rescue Stenting for Failed Mechanical Thrombectomy in Acute Basilar Artery Occlusions: Analysis of the PC-SEARCH Registry
- Creators
- Santiago Ortega-Gutierrez - University of Iowa Hospitals and ClinicsAaron Rodriguez-Calienes - University of Iowa Hospitals and ClinicsAdam Mierzwa - University of ToledoMilagros Galecio-Castillo - University of IowaMahmoud Dibas - University of IowaSami Al Kasab - Medical University of South CarolinaAshley M Nelson - Medical University of South CarolinaAshutosh P Jadhav - University of Pittsburgh Medical CenterShashvat M Desai - University of Pittsburgh Medical CenterGabor Toth - Cleveland ClinicAnas Alrohimi - Cleveland ClinicMohamad Abdalkader - Boston Medical CenterPiers Klein - Boston Medical CenterThanh N. Nguyen - Boston Medical CenterHisham Salahuddin - Antelope Valley HospitalAditya S Pandey - University of MichiganSravanthi Koduri - University of MichiganNirav Vora - Riverside Methodist HospitalNameer Aladamat - University of ToledoKhaled Gharaibeh - University of ToledoEhad Afreen - University of ToledoSyed F Zaidi - University of ToledoMouhammad A Jumaa - University of Toledo
- Resource Type
- Journal article
- Publication Details
- Stroke (1970), Vol.56(2), pp.401-412
- DOI
- 10.1161/STROKEAHA.124.047694
- PMID
- 39571537
- NLM abbreviation
- Stroke
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Language
- English
- Electronic publication date
- 11/21/2024
- Date published
- 02/2025
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984751756402771
Metrics
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