Intracranial Stenting as a Rescue Therapy for Acute Ischemic Stroke After Stentriever Thrombectomy Failure

To evaluate the efficacy and safety of intracranial stenting as a rescue therapy for acute ischemic stroke (AIS) after stentriever thrombectomy failure. Patients who received intracranial stenting as a rescue therapy for AIS after failure of stent retrieval with or without concomitant treatment between January 2014 and December 2016 were retrospectively analyzed. Recanalization results and outcome at 3 months were assessed, and perioperative complications related to the procedure were recorded. A total of 193 patients with AIS received stent retriever thrombectomy. Initial successful recanalization with stent retriever was achieved in 125 patients. Among the 68 patients with stent retrieval failure, 47 patients received stent placement as rescue therapy, and successful recanalization was achieved in 38 patients. The rate of successful recanalization, favorable outcome at 90 days, mortality, and symptomatic intracerebral hemorrhage were comparable between the stenting group and no-stenting group; however, the time from groin puncture to recanalization was significantly longer in the stenting group (P = 0.03). Compared with anterior circulation stroke, the rate of stent placement was significantly greater (P = 0.041) and the intracerebral hemorrhage rate was lower in the patients with posterior circulation stroke who received stent placement. Intracranial stenting as a rescue therapy for AIS after failure of Solitaire retrieval stent is feasible and safe. AIS of posterior circulation showed greater intracranial stent placement than anterior circulation. •This study assessed the limitations of a Solitaire-assisted thrombectomy in patients with AIS.•Permanent stenting may be a rescue modality for stentriever-failed large artery occlusion.•There are differences in the treatment of anterior and posterior circulation.