Intracranial stenting as a rescue therapy for acute anterior large vessel occlusive stroke after retrievable stent thrombectomy failure / 中华神经医学杂志

ABSTRACT

Objective To evaluate the efficacy and safety of intracranial stenting as a rescue therapy for acute anterior large vessel occlusive stroke after stentriever thrombectomy failure.Methods A total of 60 patients with acute anterior large vessel occlusive stroke failed to stent retriever thrombectomy in our hospital from January 2014 to December 2017 were chosen in our study.Among the 60 patients with stent retrieval failure,43 patients received stent placement as rescue therapy (stenting rescue group),and 17 patients received other methods as rescue therapy (non-stenting rescue group).Modified thrombolysis in cerebral infarction grading was applied to evaluate vascular re-canalization immediately after operation;modified Rankin scale (mRS) was applied to determine the prognoses of the patients 90 d after operation;the occurrences of symptomatic intracranial hemorrhage and stent re-stenosis within 6 months after operation were recorded in the two groups.Results As compared with those in the non-stenting rescue group,the rate of immediate postoperative vascular re-canalization and favorable prognosis rate in the stenting rescue group (35.29％ vs.81.40％ and 23.53％ vs.53.49％)were statistically higher (P＜0.05).There were no statistically significant differences in proportions of symptomatic intracranial hemorrhage and death between the stenting rescue group and non-stenting rescue group (11.76％ vs.13.95％;29.41％ vs.23.26％,P＞0.05).DSA follow-up showed that 4 patients in the stenting rescue group had stent re-stenosis,but all of them were asymptomatic.Conclusions Intracranial stenting as a rescue therapy for acute anterior large vessel occlusive stroke after failure of retrieval stent is feasible and safe.