Titre
Rescue therapy after failed thrombectomy in medium/distal vessel occlusions: A retrospective analysis of an international, multi-center registry.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Anastasiou, A.
Auteure/Auteur
Brehm, A.
Auteure/Auteur
Dobrocky, T.
Auteure/Auteur
Mujanovic, A.
Auteure/Auteur
de Dios Lascuevas, M.
Auteure/Auteur
Carmona Fuentes, T.
Auteure/Auteur
López-Frías López-Jurado, A.
Auteure/Auteur
Hidalgo Valverde, B.
Auteure/Auteur
Berlis, A.
Auteure/Auteur
Maurer, C.J.
Auteure/Auteur
Nguyen, T.N.
Auteure/Auteur
Abdalkader, M.
Auteure/Auteur
Klein, P.
Auteure/Auteur
Thevoz, G.
Auteure/Auteur
Michel, P.
Auteure/Auteur
Kaschner, M.
Auteure/Auteur
Weiss, D.
Auteure/Auteur
Alexandre, A.M.
Auteure/Auteur
Pedicelli, A.
Auteure/Auteur
Machi, P.
Auteure/Auteur
Bernava, G.
Auteure/Auteur
Kuwahara, S.
Auteure/Auteur
Uchida, K.
Auteure/Auteur
Wenderoth, J.
Auteure/Auteur
Joshi, A.
Auteure/Auteur
Karwacki, G.
Auteure/Auteur
Lakatos, L.B.
Auteure/Auteur
Tessitore, A.
Auteure/Auteur
Vinci, S.L.
Auteure/Auteur
Cervo, A.
Auteure/Auteur
Rollo, C.
Auteure/Auteur
Hui, F.
Auteure/Auteur
Mozumder, A.S.
Auteure/Auteur
Romano, D.G.
Auteure/Auteur
Flora, G.
Auteure/Auteur
Goyal, N.
Auteure/Auteur
Batra, V.
Auteure/Auteur
Inoa, V.
Auteure/Auteur
Cognard, C.
Auteure/Auteur
Hoferica, M.
Auteure/Auteur
Rautio, R.
Auteure/Auteur
Kaiser, D.
Auteure/Auteur
Alph, H.
Auteure/Auteur
Clarke, J.
Auteure/Auteur
Hug, N.
Auteure/Auteur
Koch, A.
Auteure/Auteur
Schulze-Zachau, V.
Auteure/Auteur
Rommers, N.
Auteure/Auteur
Katan, M.
Auteure/Auteur
Psychogios, M.N.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
2396-9881
Statut éditorial
Accepté (sous presse)
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Publication Status: aheadofprint
Résumé
There are limited therapeutic options in cases of failed reperfusion (modified thrombolysis in cerebral infarction [mTICI] score < 2b) after stent-retriever and/or aspiration based endovascular treatment (EVT) for acute ischemic stroke. Despite the absence of data supporting its use, rescue therapy (balloon angioplasty and/or stent implantation) is often utilized in such cases. Studies are limited to large vessel occlusions, while the outcomes and complications after rescue therapy in medium/distal vessel occlusions (MDVOs) have not been reported. This study aims to report the outcomes of rescue therapy in MDVO stroke patients.
We performed an analysis of the "Blood pressure and Antiplatelet medication management after reScue angioplasty after failed Endovascular treatment in Large and distal vessel occlusions with probable IntraCranial Atherosclerotic Disease" (BASEL ICAD) retrospective registry. All MDVO stroke patients were included in the analysis.
Out of the 718 registry patients, 87 (12.1%) presented with an MDVO. Fifty-six patients (64.4%) showed an occlusion of the M2 segment of the middle cerebral artery. Rescue stenting was performed in 78 patients (89.7%) while balloon angioplasty alone was performed in 9 patients (10.3%). Successful reperfusion (mTICI score ⩾ 2b) was achieved in 73 (83.9%) patients after rescue therapy. Symptomatic intracranial hemorrhage (sICH) occurred in 8 patients (9.2%) and post-treatment stent occlusion in 12 patients (13.8%). Ninety days mortality was 20.7%. Twenty-eight patients (32.2%) achieved functional independence at 90 days (modified Rankin Scale 0-2).
Rescue therapy with stenting and/or balloon angioplasty in patients undergoing EVT for isolated MDVO with suspected underlying intracranial atherosclerotic disease is an effective reperfusion strategy but is associated with complications and poor functional outcomes.
We performed an analysis of the "Blood pressure and Antiplatelet medication management after reScue angioplasty after failed Endovascular treatment in Large and distal vessel occlusions with probable IntraCranial Atherosclerotic Disease" (BASEL ICAD) retrospective registry. All MDVO stroke patients were included in the analysis.
Out of the 718 registry patients, 87 (12.1%) presented with an MDVO. Fifty-six patients (64.4%) showed an occlusion of the M2 segment of the middle cerebral artery. Rescue stenting was performed in 78 patients (89.7%) while balloon angioplasty alone was performed in 9 patients (10.3%). Successful reperfusion (mTICI score ⩾ 2b) was achieved in 73 (83.9%) patients after rescue therapy. Symptomatic intracranial hemorrhage (sICH) occurred in 8 patients (9.2%) and post-treatment stent occlusion in 12 patients (13.8%). Ninety days mortality was 20.7%. Twenty-eight patients (32.2%) achieved functional independence at 90 days (modified Rankin Scale 0-2).
Rescue therapy with stenting and/or balloon angioplasty in patients undergoing EVT for isolated MDVO with suspected underlying intracranial atherosclerotic disease is an effective reperfusion strategy but is associated with complications and poor functional outcomes.
PID Serval
serval:BIB_887D00CD645C
PMID
Date de création
2025-01-10T14:10:20.671Z
Date de création dans IRIS
2025-05-21T03:21:11Z