International Stroke Conference 2025  /  Neuroendovascular Posters II  /  Rescue Angioplasty with or without stenting after failed thrombectomy in Medium / Distal Vessel Occlusions: A retrospective analysis of a large international multi-center registry.
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American Heart Association

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Final ID: TP239

Rescue Angioplasty with or without stenting after failed thrombectomy in Medium / Distal Vessel Occlusions: A retrospective analysis of a large international multi-center registry.

Abstract Body: Background
There are limited therapy options in case of failed reperfusion after stent-retriever and/or aspiration based endovascular treatment (EVT) for acute ischemic stroke. Despite the absence of data supporting its use, rescue angioplasty (RA; with or without stent implantation) is often utilized in such cases. Studies are limited to large vessel occlusions, while the outcomes and complications after RA in medium/distal vessel occlusions (MDVOs) have not been reported. This study aims to report the outcomes of RA in MDVO stroke patients.

Methods
We performed a retrospective sub-analysis of the “Blood pressure and Antiplatelet medication management after reScue angioplasty after failed Endovascular treatment in Large and distal vessel occlusions with probable IntraCranial Atherosclerotic Disease” (BASEL ICAD) registry. All MDVO stroke patients were included in the analysis.

Results
Out of 718 patients, 92 (12.8%) presented with an MDVO. Sixty-one patients (65.9%) presented with an occlusion of the M2 segment of the middle cerebral artery. Rescue stenting (RS) was performed in 83 patients (90.2%) and balloon angioplasty alone was performed in 9 patients (9.8%). Successful reperfusion (modified thrombolysis in cerebral infarction (mTICI) score ≥ 2b) before RA was achieved in 34 patients (36.9%) and after RA in 76 (82.6%) patients. Symptomatic intracranial hemorrhage (sICH) occurred in 8 patients (9.1%) and post-treatment stent occlusion in 14 patients (16.7%). 90 days mortality was 24.1%. Twenty-nine patients (34.9%) achieved functional independence at 90 days (modified Rankin Scale 0 – 2).

Conclusion
Rescue Angioplasty might be a viable treatment option in case of failed reperfusion after conventional EVT in selected MDVO patients. However, safety concerns remain.
  • Anastasiou, Aikaterini  ( University Hospital Basel , Basel , Switzerland )
  • Kuwahara, Shuntaro  ( Hyogo Medical University , Nishinomiya , Japan )
  • Wenderoth, Jason  ( Prince of Wales Hospital , Wales , New South Wales , Australia )
  • Karwacki, Grzegorz  ( Kantonsspital Lucerne , Lucerne , Switzerland )
  • Tessitore, Agostino  ( University Hospital A.O.U. "G. Martino" - Messina , Messina , Italy )
  • Rollo, Claudia  ( ASST Grande Ospedale Metropolitano Niguarda (Niguarda Ca' Granda), Milan, Italy. , Messina , Italy )
  • Inoa, Violiza  ( Semmes-Murphey Clinic , Memphis , Tennessee , United States )
  • Rautio, Riitta  ( Turku University Hospital , Turku , Finland )
  • Romano, Daniele  ( Unit of Interventional Neuroradiology, university Hospital AOU Salerno, Italy , Salerno , Italy )
  • Clarke, Julian  ( University of Washington , Seattle , Washington , United States )
  • Hui, Ferdinand  ( University of Hawaii , Hawaii , Hawaii , United States )
  • Brehm, Alex  ( University Hospital Basel , Basel , Switzerland )
  • Weiss, Daniel Arvid  ( University Duesseldorf , Duesseldorf , Germany )
  • Cognard, Christophe  ( CHU TOULOUSE , TOULOUSE , France )
  • Schulze-zachau, Victor  ( University Hospital Basel , Basel , Switzerland )
  • Rommers, Nikki  ( University Hospital Basel , Basel , Switzerland )
  • Katan, Mira  ( University Hospital of Basel , Basel , Switzerland )
  • Psychogios, Marios  ( University Hospital Basel , Basel , Switzerland )
  • Mujanovic, Adnan  ( University Hospital Bern Inselspita , Bern , Switzerland )
  • Carmona, Tomas  ( Vall d'Hebron Hospital , Barcelona , Spain )
  • Moreu, Manuel  ( Hospital Clínico San Carlos , Madrid , Spain )
  • Maurer, Christoph  ( University Hospital Augsburg , Augsburg , Germany )
  • Nguyen, Thanh  ( Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine , Boston , Massachusetts , United States )
  • Michel, Patrik  ( CHUV , Lausanne , Switzerland )
  • Machi, Paolo  ( HUG , Geneva , Switzerland )
    • Author Disclosures:
    Aikaterini Anastasiou: DO NOT have relevant financial relationships | Shuntaro Kuwahara: DO NOT have relevant financial relationships | Jason Wenderoth: DO have relevant financial relationships ; Speaker:Terumo/Microvention:Active (exists now) | Grzegorz Karwacki: DO NOT have relevant financial relationships | Agostino Tessitore: DO NOT have relevant financial relationships | Claudia Rollo: No Answer | Violiza Inoa: DO have relevant financial relationships ; Consultant:Medtronic :Active (exists now) ; Consultant:Stryker :Active (exists now) ; Consultant:Imperative care :Active (exists now) ; Speaker:Penumbra :Active (exists now) ; Speaker:Microvention :Active (exists now) ; Research Funding (PI or named investigator):Medtronic :Past (completed) ; Speaker:Medtronic:Active (exists now) | Riitta Rautio: DO have relevant financial relationships ; Consultant:Medtronic:Active (exists now) ; Consultant:Microvention:Active (exists now) ; Consultant:Balt:Active (exists now) ; Consultant:Stryker:Active (exists now) | Daniele Romano: No Answer | Julian Clarke: DO NOT have relevant financial relationships | Ferdinand Hui: No Answer | Alex Brehm: DO NOT have relevant financial relationships | Daniel Arvid Weiss: DO NOT have relevant financial relationships | Christophe Cognard: DO have relevant financial relationships ; Consultant:Stryker:Active (exists now) ; Consultant:microvention:Active (exists now) ; Consultant:medtronic:Active (exists now) | Victor Schulze-Zachau: No Answer | Nikki Rommers: DO NOT have relevant financial relationships | Mira Katan: DO have relevant financial relationships ; Advisor:BMS:Past (completed) ; Research Funding (PI or named investigator):BRAHMS Thermofisher Scientific:Active (exists now) ; Research Funding (PI or named investigator):Swiss National Science Foundation:Active (exists now) | Marios Psychogios: DO have relevant financial relationships ; Research Funding (PI or named investigator):Penumbra Inc.:Active (exists now) ; Research Funding (PI or named investigator):Rapid Medical Inc.:Active (exists now) ; Research Funding (PI or named investigator):Phenox GmbH:Active (exists now) ; Research Funding (PI or named investigator):Stryker Neurovascular Inc.:Active (exists now) ; Research Funding (PI or named investigator):Medtronic Inc.:Active (exists now) ; Research Funding (PI or named investigator):Siemens Healthineers AG:Active (exists now) ; Speaker:Siemens Healthineers AG:Active (exists now) ; Speaker:Phenox GmbH:Active (exists now) ; Speaker:Penumbra Inc.:Active (exists now) ; Speaker:Medtronic Inc.:Active (exists now) ; Speaker:Stryker Neurovascular Inc.:Active (exists now) | Adnan Mujanovic: DO NOT have relevant financial relationships | Tomas Carmona: DO NOT have relevant financial relationships | Manuel Moreu: DO have relevant financial relationships ; Consultant:Stryker:Active (exists now) ; Individual Stocks/Stock Options:BCV:Active (exists now) ; Individual Stocks/Stock Options:Medtronic:Active (exists now) ; Consultant:Medtronic:Active (exists now) ; Consultant:Inspire:Active (exists now) ; Consultant:Balt:Active (exists now) ; Consultant:iVascular:Active (exists now) | Christoph Maurer: DO NOT have relevant financial relationships | Thanh Nguyen: DO have relevant financial relationships ; Other (please indicate in the box next to the company name):American Stroke Association:Active (exists now) ; Advisor:Aruna Bio:Past (completed) ; Advisor:Brainomix:Active (exists now) | Patrik Michel: DO have relevant financial relationships ; Research Funding (PI or named investigator):Swiss National Science Foundation:Active (exists now) ; Research Funding (PI or named investigator):Faculty of Biology and Medicine of the University of Lausanne:Past (completed) ; Research Funding (PI or named investigator):Swiss Heart Foundation:Active (exists now) | Paolo Machi: No Answer
Meeting Info:

International Stroke Conference 2025

2025

Los Angeles, CA

Session Info:

Neuroendovascular Posters II

Thursday, 02/06/2025 , 07:00PM - 07:30PM

Poster Abstract Session

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