Deans' stroke musings: Clinical outcomes of rescue stenting for failed endovascular thrombectomy: a multicenter prospective registry

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, January 13, 2022

Clinical outcomes of rescue stenting for failed endovascular thrombectomy: a multicenter prospective registry

But you don't tell us the primary outcome; 100% recovery. As such you're not even trying to get stroke survivors recovered. WHAT THE HELL ARE YOU IN STROKE FOR?

Clinical outcomes of rescue stenting for failed endovascular thrombectomy: a multicenter prospective registry

Jang-Hyun Baek1,2,
http://orcid.org/0000-0001-8593-6841Byung Moon Kim3,
Eun Hyun Ihm4,
Chang-Hyun Kim5,
http://orcid.org/0000-0002-7035-087XDong Joon Kim3,
Ji Hoe Heo2,
Hyo Suk Nam2,
Young Dae Kim2,
Sangil Suh6,
Byungjun Kim7,
Yoodong Won8,
Byung Hyun Baek9,
http://orcid.org/0000-0002-8804-1848Woong Yoon9,
http://orcid.org/0000-0002-3988-1680Hyon-Jo Kwon10,
Yoonkyung Chang11,
http://orcid.org/0000-0002-8862-7347Cheolkyu Jung12,
Hae Woong Jeong13

Correspondence to Dr Byung Moon Kim, Radiology, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of); bmoon21@hanmail.net

Abstract

Background Mechanical thrombectomy (MT) is a primary endovascular modality for acute intracranial large vessel occlusion. However, further treatment, such as rescue stenting, is occasionally necessary for refractory cases. We aimed to investigate the efficacy and safety of rescue stenting in first-line MT failure and to identify the clinical factors affecting its clinical outcome.

Methods A multicenter prospective registry was designed for this study. We enrolled consecutive patients who underwent rescue stenting for first-line MT failure. Endovascular details and outcomes, follow-up patency of the stented artery, and clinical outcomes were summarized and compared between the favorable and unfavorable outcome groups.

Results A total of 78 patients were included. Intracranial atherosclerotic stenosis was the most common etiology for rescue stenting (97.4%). Seventy-seven patients (98.7%) were successfully recanalized by rescue stenting. A favorable outcome was observed in 66.7% of patients. Symptomatic intracranial hemorrhage and mortality were observed in 5.1% and 4.0% of patients, respectively. The stented artery was patent in 82.1% of patients on follow-up angiography. In a multivariable analysis, a patent stent on follow-up angiography was an independent factor for a favorable outcome (OR 87.6; 95% CI 4.77 to 1608.9; p=0.003). Postprocedural intravenous maintenance of glycoprotein IIb/IIIa inhibitor was significantly associated with the follow-up patency of the stented artery (OR 5.72; 95% CI 1.45 to 22.6; p=0.013).

Conclusions In this multicenter prospective registry, rescue stenting for first-line MT failure was effective(What is your definition of effective? Mine is 100% recovery!) and safe. For a favorable outcome, follow-up patency of the stented artery was important, which was significantly associated with postprocedural maintenance of glycoprotein IIb/IIIa inhibitors.