SINGLE-CENTER EXPERIENCE WITH RESCUE INTRACRANIAL STENTING FOLLOWING UNSUCCESSFUL THROMBECTOMY IN ACUTE ISCHEMIC STROKE

Background:Asubset of patients with acute ischemic stroke due to large-vessel occlusion(LVO) remain refractory to mechanical thrombectomy (MT). Rescue intracranial stent placement (RS) is increasingly used as a salvage strategy to restore durable reperfusion. Objective: To report safety, technical efficacy, and clinical outcomes of rescue stent placement in a consecutive single-center cohort of 40 patients after failed MT. Methods: Retrospective observational single-center study including 40 consecutive adult patients (March 2020–June 2022) who underwent RS after failed or recurrent occlusion during MT. Primary outcome: successful reperfusion defined as final modified Thrombolysis in Cerebral Infarction (mTICI) ≥2b. Secondary outcomes: symptomatic intracranial hemorrhage (sICH) within 72 hours, 90-day functional outcome (modified Rankin Scale, mRS), in-hospital mortality, and procedure-related complications. Descriptive statistics are presented. Results: Mean age was 63.5 ± 11.2 years; 22 (55%) were male. Median baseline NIHSS was 16 (IQR 12–20). Median number of MT passes prior to RS was 3 (range 2–6). Indication for RS was angiographic evidence of underlying fixed stenosis or immediate reocclusion after retrieval. Successful reperfusion (mTICI ≥2b) was achieved in 34/40 patients (85%). sICH occurred in 3/40 patients (7.5%). At 90 days, 18/40 (45%) achieved functional independence (mRS 0–2). In-hospital mortality was 6/40 (15%). No fatal device-related perforations occurred; in-stent thrombosis was observed in 2 patients (5%) and managed endovascularly. Conclusion:In this 40-patient observational series, rescue intracranial stent placement after failed MTachieved high rates of final reperfusion (85%) with an acceptable safety profile in experienced hands. These results support consideration of RS as a salvage option for selected patients; prospective studies and standardized antithrombotic protocols are required.