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Clinical outcomes of rescue stenting for failed endovascular thrombectomy: a multicenter prospective registry

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Author(s)
Jang-Hyun BaekByung Moon KimEun Hyun IhmChang-Hyun KimDong Joon KimJi Hoe HeoHyo Suk NamYoung Dae KimSangil SuhByungjun KimYoodong WonByung Hyun BaekWoong YoonHyon-Jo KwonYoonkyung ChangCheolkyu JungHae Woong Jeong
Keimyung Author(s)
Kim, Chang Hyun
Department
Dept. of Neurosurgery (신경외과학)
Journal Title
J Neurointerv Surg
Issued Date
2022
Volume
14
Issue
12
Abstract
Background:
Mechanical thrombectomy (MT) is a primary endovascular modality for acute intracranial large vessel occlusion. However, further treatment, such as rescue stenting, is occasionally necessary for refractory cases. We aimed to investigate the efficacy and safety of rescue stenting in first-line MT failure and to identify the clinical factors affecting its clinical outcome.

Methods:
A multicenter prospective registry was designed for this study. We enrolled consecutive patients who underwent rescue stenting for first-line MT failure. Endovascular details and outcomes, follow-up patency of the stented artery, and clinical outcomes were summarized and compared between the favorable and unfavorable outcome groups.

Results:
A total of 78 patients were included. Intracranial atherosclerotic stenosis was the most common etiology for rescue stenting (97.4%). Seventy-seven patients (98.7%) were successfully recanalized by rescue stenting. A favorable outcome was observed in 66.7% of patients. Symptomatic intracranial hemorrhage and mortality were observed in 5.1% and 4.0% of patients, respectively. The stented artery was patent in 82.1% of patients on follow-up angiography. In a multivariable analysis, a patent stent on follow-up angiography was an independent factor for a favorable outcome (OR 87.6; 95% CI 4.77 to 1608.9; p=0.003). Postprocedural intravenous maintenance of glycoprotein IIb/IIIa inhibitor was significantly associated with the follow-up patency of the stented artery (OR 5.72; 95% CI 1.45 to 22.6; p=0.013).

Conclusions:
In this multicenter prospective registry, rescue stenting for first-line MT failure was effective and safe. For a favorable outcome, follow-up patency of the stented artery was important, which was significantly associated with postprocedural maintenance of glycoprotein IIb/IIIa inhibitors.
Keimyung Author(s)(Kor)
김창현
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1759-8486
Source
https://jnis.bmj.com/content/early/2022/01/11/neurintsurg-2021-018308
DOI
10.1136/neurintsurg-2021-018308
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44688
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학)
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