Comparative Safety and Efficacy of Balloon-Mounted and Self-Expanding Stents in Rescue Stenting for Large Vessel Occlusion: Secondary Analysis of the RESCUE-ICAS Registry
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Le résumé fourni par la source
ABSTRACT BACKGROUND AND PURPOSE: Patients with intracranial stenosis-related large vessel occlusion (ICAS-LVO) may experience better outcomes with stenting compared to standalone mechanical thrombectomy. This study evaluates the safety and clinical outcomes of self-expanding stents (SES) versus balloon-mounted stents (BMS) in ICAS-LVO patients treated with mechanical thrombectomy and stenting. MATERIALS AND METHODS: This secondary analysis of the RESCUE-ICAS registry, a multicenter observational study, included ICASLVO patients from 25 stroke centers who underwent stenting. Patients were stratified by stent type (SES or BMS). The primary endpoint was 90-day modified Rankin Scale (mRS) 0–2. Secondary outcomes included successful reperfusion, recurrent stroke, and infarct volume. Symptomatic intracranial hemorrhage was the primary safety outcome. Inverse probability weighting adjusted for confounders. RESULTS: Among 194 patients, 111 received SES, of whom 61 (55%) underwent pre-stenting angioplasty. After adjustment, no significant difference was observed between SES and BMS in 90-day mRS 0–2 (OR 1.10, 95% CI 0.62–1.96, p=0.75), successful reperfusion (mTICI ≥2B), or final infarct volume. SES was associated with higher odds of moderate stenosis (>50%) at follow-up (OR 3.7, 95% CI 1.15–11.98, p=0.02) and recurrent stroke (13.5% vs. 1.2%, p=0.001), particularly in patients without pre-stenting angioplasty (14% vs. 1%). CONCLUSIONS: SES and BMS demonstrated comparable safety and clinical outcomes in ICAS-LVO patients. However, SES was linked to higher rates of restenosis and recurrent strokes, potentially influenced by the absence of pre-stenting angioplasty. Further research is needed to refine stenting strategies in this population. ABBREVIATIONS: BMS = balloon mounted stents, ICAS = intracranial atherosclerotic stenosis, IPW = Inverse probability weighted, MT = mechanical thrombectomy, LVO = Large vessel occlusion, RS = rescue stenting, RESCUE-ICAS = Registry of Emergent Large Vessel Occlusion due to Intracranial Stenosis, SES = self-expanding stents (SES)
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Comparative Safety and Efficacy of Balloon-Mounted and Self-Expanding Stents in Rescue Stenting for Large Vessel Occlusion: Secondary Analysis of the RESCUE-ICAS Registry
- Date Crossref
- 23/06/2025
- Éditeur
- American Society of Neuroradiology (ASNR)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Medical University of South Carolina I.S.T.) pays non établi dans la noticeUniversité ou école supérieure
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University of Toledo Department of Neurology (A.T.M. pays non établi dans la noticeUniversité ou école supérieure
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Brown University Department of Neurology (S.Y.) pays non établi dans la noticeUniversité ou école supérieure
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University of Tennessee Health Science Center Semmes Murphey Clinic (V.I.) pays non établi dans la noticeUniversité ou école supérieure
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Semmes Murphey Foundation pays non établi dans la noticeOrganisation à but non lucratif
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Azienda Ospedaliero-Universitaria Careggi pays non établi dans la noticeÉtablissement de santé
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University of Houston pays non établi dans la noticeUniversité ou école supérieure
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The University of Texas Health Science Center at Houston Department of Neurology (M.N.) pays non établi dans la noticeUniversité ou école supérieure
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University of Miami Department of Neurosurgery (R.M.S.) pays non établi dans la noticeUniversité ou école supérieure
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University of Miami Hospital pays non établi dans la noticeÉtablissement de santé
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Hospital de São José pays non établi dans la noticeÉtablissement de santé
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University of Rochester Medicine pays non établi dans la noticeÉtablissement de santé
I.S.T.) — Medical University of South Carolina, Department of Neurology (A.T.M. — University of Toledo et Department of Neurology (S.Y.) — Brown University, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.