Rescue Strategies in Anterior Circulation Stroke with Failed Mechanical Thrombectomy A Retrospective Observational Study

Context: Recanalization failure rate in mechanical thrombectomy (MT) for large vessel occlusions is up to 30%. Outcome greatly depends on recanalization success and, thus, there is an urgent need to adopt new strategies to improve recanalization. Aims: To report on the feasibility, safety, and outcome of rescue strategies (stenting and/or angioplasty) in cases of failed MT for acute ischemic stroke (AIS) in anterior circulation.

Materials and Methods: It was a retrospective observational study where patients undergoing MT were divided into two groups. The first group (MT only) was of patients who had undergone only MT with the standard tools (stentriever and/or aspiration). The second group (MT plus) consisted of patients who underwent a rescue procedure after failure of the standard MT. The two groups were compared based on the demographics, risk factors, stroke severity, and the extent of infarct on imaging. The angiographic findings, procedural details, periprocedural care, and angiographic and clinical outcome were also compared. Results: Out of 181 cases, 142 were in MT only while 39 were included in MT plus group.

Author(s): Vikram Huded

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