Mahmoud H Mohammaden, Pedro N Martins, Hassan Aboul-Nour, Alhamza R Al-Bayati, Ameer E Hassan, Wondwossen Tekle, Johanna T Fifi, Shahram Majidi, Okkes Kuybu, Bradley A Gross, Michael Lang, Gustavo M Cortez, Ricardo A Hanel, Amin Aghaebrahim, Eric Sauvageau, Mohamed A Tarek, Mudassir Farooqui, Santiago Ortega-Gutierrez, Cynthia B Zevallos, Milagros Galecio-Castillo, Sunil A Sheth, Michael Nahhas, Sergio Salazar-Marioni, Thanh N Nguyen, Mohamad Abdalkader, Piers Klein, Muhammad Hafeez, Peter Kan, Omar Tanweer, Ahmad Khaldi, Hanzhou Li, Mouhammad Jumaa, Syed F Zaidi, Marion Oliver, Mohamed M Salem, Jan-Karl Burkhardt, Bryan Pukenas, Nicholas Vigilante, Mary Penckofer, James E Siegler, Sophia Peng, Ali Alaraj, Jonathan A Grossberg, Raul Nogueira, Diogo C Haussen
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引用次数: 0
Abstract
Background: Previous studies have shown that when thrombectomy has failed, rescue intracranial stenting is associated with better clinical outcomes compared with failed reperfusion. However, comparative data regarding stent type are lacking.
Objective: To compare the procedural and clinical outcomes of balloon-mounted stents (BMS) with those of self-expandable stents (SES).
Methods: Retrospective analysis of a prospectively collected database from the Stenting and Angioplasty in NeuroThrombectomy (SAINT) consortium. Patients were included if thrombectomy had failed and they then underwent rescue emergency stenting. Patients treated with SES or BMS were compared using inverse probability of treatment weighting. The primary outcome was the final reperfusion as measured by the modified Thrombolysis in Cerebral Infarction (mTICI) Scale. Safety measures included rates of symptomatic intracranial hemorrhage, procedural complications, and 90-day mortality.
Results: A total of 328 patients were included. Baseline clinical and procedural characteristics were well balanced among both groups. The BMS group (n=127) had higher rates of successful reperfusion (94.5% vs 86.6%, aOR=4.23, 95% CI 1.57 to 11.37, P=0.004) and increased likelihood of higher degree of final reperfusion on the mTICI Scale (acOR=2.06, 95% CI 1.19 to 3.57, P=0.01) than the SES group (n=201). No difference in modified Rankin Scale shift (acOR=0.98, 95% CI 0.54 to 1.79, P=0.95), rates of mRS0-2 (26% vs 36%, aOR=0.93, 95% CI 0.46 to 1.88, P=0.83) and mRS0-3 (43% vs 50%, aOR=0.92, 95% CI 0.51 to 1.66, P=0.77) at 90 days were noted. Safety measures were comparable in both groups.
Conclusion: The present study demonstrates higher reperfusion rates with BMS than with SES in failed thrombectomy procedures that involved rescue stenting. No differences in hemorrhagic complications or clinical outcomes were noted. Further larger controlled studies are warranted.
期刊介绍：
The Journal of NeuroInterventional Surgery (JNIS) is a leading peer review journal for scientific research and literature pertaining to the field of neurointerventional surgery. The journal launch follows growing professional interest in neurointerventional techniques for the treatment of a range of neurological and vascular problems including stroke, aneurysms, brain tumors, and spinal compression.The journal is owned by SNIS and is also the official journal of the Interventional Chapter of the Australian and New Zealand Society of Neuroradiology (ANZSNR), the Canadian Interventional Neuro Group, the Hong Kong Neurological Society (HKNS) and the Neuroradiological Society of Taiwan.
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