Intracranial Stenting as Rescue Therapy After Failure of Mechanical Thrombectomy for Basilar Artery Occlusion: Data From the ANGEL-ACT Registry
Background and Purpose: Studies on rescue therapy for acute posterior circulation stroke due to basilar artery occlusion (BAO) are limited in the modern era of mechanical thrombectomy (MT). The aim of this study was to evaluate the safety and efficacy of rescue stenting (RS) following MT failure in...
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Frontiers Media S.A.
2021-09-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.739213/full |
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| author | Gang Luo Gang Luo Feng Gao Feng Gao Xuelei Zhang Xuelei Zhang Xuelei Zhang Baixue Jia Baixue Jia Xiaochuan Huo Xiaochuan Huo Raynald Liu Raynald Liu Man Sum Chi Man Sum Chi Man Sum Chi Gaoting Ma Gaoting Ma Guangge Peng Guangge Peng Jingyu Zhang Jingyu Zhang Zhongqi Qi Zhongqi Qi Xu Guo Xu Guo Xu Guo Bin Han Bin Han Bin Han Xu Tong Xu Tong Bo Wang Bo Wang Ligang Song Ligang Song Lian Liu Lian Liu Zijun He Zijun He Dapeng Mo Dapeng Mo Ning Ma Ning Ma Xuan Sun Xuan Sun Ming Yang Ming Yang Zhongrong Miao Zhongrong Miao |
| author_facet | Gang Luo Gang Luo Feng Gao Feng Gao Xuelei Zhang Xuelei Zhang Xuelei Zhang Baixue Jia Baixue Jia Xiaochuan Huo Xiaochuan Huo Raynald Liu Raynald Liu Man Sum Chi Man Sum Chi Man Sum Chi Gaoting Ma Gaoting Ma Guangge Peng Guangge Peng Jingyu Zhang Jingyu Zhang Zhongqi Qi Zhongqi Qi Xu Guo Xu Guo Xu Guo Bin Han Bin Han Bin Han Xu Tong Xu Tong Bo Wang Bo Wang Ligang Song Ligang Song Lian Liu Lian Liu Zijun He Zijun He Dapeng Mo Dapeng Mo Ning Ma Ning Ma Xuan Sun Xuan Sun Ming Yang Ming Yang Zhongrong Miao Zhongrong Miao |
| author_sort | Gang Luo |
| collection | DOAJ |
| description | Background and Purpose: Studies on rescue therapy for acute posterior circulation stroke due to basilar artery occlusion (BAO) are limited in the modern era of mechanical thrombectomy (MT). The aim of this study was to evaluate the safety and efficacy of rescue stenting (RS) following MT failure in patients with BAO.Methods: Data were collected from the Endovascular Treatment Key Technique and Emergency Work Flow Improvement of Acute Ischemic Stroke (ANGEL-ACT) prospective registry in China. Patients who underwent MT for BAO with failure of recanalization were enrolled in this study. The patients were divided into the RS and non-RS groups. Clinical and laboratory findings, procedural details, and clinical outcomes were compared between the two groups.Results: Overall, 93 patients with acute BAO were analyzed. The RS group included 81 (87.1%) patients, and the non-RS group included 12 patients. A modified treatment in cerebral infarction (mTICI) score of 2b/3 was achieved in 75 (92.6%) patients in the RS group. Compared with the non-RS group, the RS group had a significantly higher rate of successful recanalization and favorable clinical outcomes (modified Rankin Scale score at 90 days post-procedure, 0–3: 16.7 vs. 51.9%, respectively; P = 0.023) without an increase in the rate of symptomatic intracranial hemorrhage and a significantly lower mortality rate (58.3 vs. 18.5%, respectively; P = 0.006). Furthermore, the use of a glycoprotein IIb/IIIa inhibitor improved the rate of recanalization of the target artery without increasing the rate of symptomatic intracranial hemorrhage.Conclusions: Permanent stenting appears to be a feasible rescue modality when MT fails and might provide functional benefits in patients with acute ischemic stroke due to BAO. |
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| spelling | doaj.art-c2166f5121f04536bc6f8452b4ea7a292022-12-21T21:49:52ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-09-011210.3389/fneur.2021.739213739213Intracranial Stenting as Rescue Therapy After Failure of Mechanical Thrombectomy for Basilar Artery Occlusion: Data From the ANGEL-ACT RegistryGang Luo0Gang Luo1Feng Gao2Feng Gao3Xuelei Zhang4Xuelei Zhang5Xuelei Zhang6Baixue Jia7Baixue Jia8Xiaochuan Huo9Xiaochuan Huo10Raynald Liu11Raynald Liu12Man Sum Chi13Man Sum Chi14Man Sum Chi15Gaoting Ma16Gaoting Ma17Guangge Peng18Guangge Peng19Jingyu Zhang20Jingyu Zhang21Zhongqi Qi22Zhongqi Qi23Xu Guo24Xu Guo25Xu Guo26Bin Han27Bin Han28Bin Han29Xu Tong30Xu Tong31Bo Wang32Bo Wang33Ligang Song34Ligang Song35Lian Liu36Lian Liu37Zijun He38Zijun He39Dapeng Mo40Dapeng Mo41Ning Ma42Ning Ma43Xuan Sun44Xuan Sun45Ming Yang46Ming Yang47Zhongrong Miao48Zhongrong Miao49Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaBeijing Institute of Brain Disorders, Capital Medical University, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaDepartment of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong, SAR ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaDepartment of Neurology, Shanxi Provincial People's Hospital, Taiyuan, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaDepartment of Interventional Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaInterventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaBackground and Purpose: Studies on rescue therapy for acute posterior circulation stroke due to basilar artery occlusion (BAO) are limited in the modern era of mechanical thrombectomy (MT). The aim of this study was to evaluate the safety and efficacy of rescue stenting (RS) following MT failure in patients with BAO.Methods: Data were collected from the Endovascular Treatment Key Technique and Emergency Work Flow Improvement of Acute Ischemic Stroke (ANGEL-ACT) prospective registry in China. Patients who underwent MT for BAO with failure of recanalization were enrolled in this study. The patients were divided into the RS and non-RS groups. Clinical and laboratory findings, procedural details, and clinical outcomes were compared between the two groups.Results: Overall, 93 patients with acute BAO were analyzed. The RS group included 81 (87.1%) patients, and the non-RS group included 12 patients. A modified treatment in cerebral infarction (mTICI) score of 2b/3 was achieved in 75 (92.6%) patients in the RS group. Compared with the non-RS group, the RS group had a significantly higher rate of successful recanalization and favorable clinical outcomes (modified Rankin Scale score at 90 days post-procedure, 0–3: 16.7 vs. 51.9%, respectively; P = 0.023) without an increase in the rate of symptomatic intracranial hemorrhage and a significantly lower mortality rate (58.3 vs. 18.5%, respectively; P = 0.006). Furthermore, the use of a glycoprotein IIb/IIIa inhibitor improved the rate of recanalization of the target artery without increasing the rate of symptomatic intracranial hemorrhage.Conclusions: Permanent stenting appears to be a feasible rescue modality when MT fails and might provide functional benefits in patients with acute ischemic stroke due to BAO.https://www.frontiersin.org/articles/10.3389/fneur.2021.739213/fullbasilar artery occlusionmechanical thrombectomyrescue stentingposterior circulationacute strokerecanalization |
| spellingShingle | Gang Luo Gang Luo Feng Gao Feng Gao Xuelei Zhang Xuelei Zhang Xuelei Zhang Baixue Jia Baixue Jia Xiaochuan Huo Xiaochuan Huo Raynald Liu Raynald Liu Man Sum Chi Man Sum Chi Man Sum Chi Gaoting Ma Gaoting Ma Guangge Peng Guangge Peng Jingyu Zhang Jingyu Zhang Zhongqi Qi Zhongqi Qi Xu Guo Xu Guo Xu Guo Bin Han Bin Han Bin Han Xu Tong Xu Tong Bo Wang Bo Wang Ligang Song Ligang Song Lian Liu Lian Liu Zijun He Zijun He Dapeng Mo Dapeng Mo Ning Ma Ning Ma Xuan Sun Xuan Sun Ming Yang Ming Yang Zhongrong Miao Zhongrong Miao Intracranial Stenting as Rescue Therapy After Failure of Mechanical Thrombectomy for Basilar Artery Occlusion: Data From the ANGEL-ACT Registry Frontiers in Neurology basilar artery occlusion mechanical thrombectomy rescue stenting posterior circulation acute stroke recanalization |
| title | Intracranial Stenting as Rescue Therapy After Failure of Mechanical Thrombectomy for Basilar Artery Occlusion: Data From the ANGEL-ACT Registry |
| title_full | Intracranial Stenting as Rescue Therapy After Failure of Mechanical Thrombectomy for Basilar Artery Occlusion: Data From the ANGEL-ACT Registry |
| title_fullStr | Intracranial Stenting as Rescue Therapy After Failure of Mechanical Thrombectomy for Basilar Artery Occlusion: Data From the ANGEL-ACT Registry |
| title_full_unstemmed | Intracranial Stenting as Rescue Therapy After Failure of Mechanical Thrombectomy for Basilar Artery Occlusion: Data From the ANGEL-ACT Registry |
| title_short | Intracranial Stenting as Rescue Therapy After Failure of Mechanical Thrombectomy for Basilar Artery Occlusion: Data From the ANGEL-ACT Registry |
| title_sort | intracranial stenting as rescue therapy after failure of mechanical thrombectomy for basilar artery occlusion data from the angel act registry |
| topic | basilar artery occlusion mechanical thrombectomy rescue stenting posterior circulation acute stroke recanalization |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2021.739213/full |
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