Stenting and Angioplasty in Neurothrombectomy: Matched Analysis of Rescue Intracranial Stenting Versus Failed Thrombectomy

作者：Mahmoud Mohammaden, Diogo C Haussen, Alhamza R Al‐Bayati, Ameer E Hassan, Wondwossen Tekle, Johanna T Fifi, Stavros Matsoukas, Okkes Kuybu, Bradley A. Gross, Michael J. Lang, Sandra Narayanan, Gustavo M Cortez, Ricardó A. Hanel, Amin Aghaebrahim, Eric Sauvageau, Mudassir Farooqui, Santiago Ortega‐Gutiérrez, Cynthia Zevallos, Milagros Galecio‐Castillo, Sunil A. Sheth, Michael Nahhas, Sergio Salazar‐Marioni, Thanh N. Nguyen, Mohamad Abdalkader, Piers Klein, Muhammad Ubaid Hafeez, Peter Kan, Omar Tanweer, Ahmad Khaldi, Hanzhou Li, Mouhammad Jumaa, Syed Zaidi, Marion Oliver, Mohamed M. Salem, Jan‐Karl Burkhardt, Bryan Pukenas, Ali Alaraj, Sophia Peng, Rahul Kumar, Michael Lai, James E. Siegler, Raul G. Nogueira · 发表于：Stroke · 年份：2022 · DOI：10.1161/strokeaha.121.038248 · 被引用次数：85 · 研究领域：Acute Ischemic Stroke Management、Cerebrovascular and Carotid Artery Diseases、Intracranial Aneurysms: Treatment and Complications

Background: Successful reperfusion is one of the strongest predictors of functional outcomes after mechanical thrombectomy (MT). Despite continuous advancements in MT technology and techniques, reperfusion failure still occurs in ≈15% to 30% of patients with large vessel occlusion strokes undergoing MT. We aim to evaluate the safety and efficacy of rescue intracranial stenting for large vessel occlusion stroke after failed MT. Methods: The SAINT (Stenting and Angioplasty in Neurothrombectomy) Study is a retrospective analysis of prospectively collected data from 14 comprehensive stroke centers through January 2015 to December 2020. Patients were included if they had anterior circulation large vessel occlusion stroke due to intracranial internal carotid artery and middle cerebral artery-M1/M2 segments and failed MT. The cohort was divided into 2 groups: rescue intracranial stenting and failed recanalization (modified Thrombolysis in Cerebral Ischemia score 0–1). Propensity score matching was used to balance the 2 groups. The primary outcome was the shift in the degree of disability as measured by the modified Rankin Scale at 90 days. Secondary outcomes included functional independence (90-day modified Rankin Scale score 0–2). Safety measures included symptomatic intracranial hemorrhage and 90-day mortality. Results: A total of 499 patients were included in the analysis. Compared with the failed reperfusion group, rescue intracranial stenting had a favorable shift in the overal...