TY - JOUR
T1 - Balloon-mounted versus self-expandable stent in failed neurothrombectomy
T2 - a post hoc analysis of the SAINT study
AU - Mohammaden, Mahmoud H.
AU - Martins, Pedro N.
AU - Aboul-Nour, Hassan
AU - Al-Bayati, Alhamza R.
AU - Hassan, Ameer E.
AU - Tekle, Wondwossen
AU - Fifi, Johanna T.
AU - Majidi, Shahram
AU - Kuybu, Okkes
AU - Gross, Bradley A.
AU - Lang, Michael
AU - Cortez, Gustavo M.
AU - Hanel, Ricardo A.
AU - Aghaebrahim, Amin
AU - Sauvageau, Eric
AU - Tarek, Mohamed A.
AU - Farooqui, Mudassir
AU - Ortega-Gutierrez, Santiago
AU - Zevallos, Cynthia B.
AU - Galecio-Castillo, Milagros
AU - Sheth, Sunil A.
AU - Nahhas, Michael
AU - Salazar-Marioni, Sergio
AU - Nguyen, Thanh N.
AU - Abdalkader, Mohamad
AU - Klein, Piers
AU - Hafeez, Muhammad
AU - Kan, Peter
AU - Tanweer, Omar
AU - Khaldi, Ahmad
AU - Li, Hanzhou
AU - Jumaa, Mouhammad
AU - Zaidi, Syed F.
AU - Oliver, Marion
AU - Salem, Mohamed M.
AU - Burkhardt, Jan Karl
AU - Pukenas, Bryan
AU - Vigilante, Nicholas
AU - Penckofer, Mary
AU - Siegler, James E.
AU - Peng, Sophia
AU - Alaraj, Ali
AU - Grossberg, Jonathan A.
AU - Nogueira, Raul
AU - Haussen, Diogo C.
N1 - Publisher Copyright:
© 2025 BMJ Publishing Group. All rights reserved.
PY - 2025/5/1
Y1 - 2025/5/1
N2 - Background Previous studies have shown that when thrombectomy has failed, rescue intracranial stenting is associated with better clinical outcomes compared with failed reperfusion. However, comparative data regarding stent type are lacking. Objective To compare the procedural and clinical outcomes of balloon-mounted stents (BMS) with those of self-expandable stents (SES). Methods Retrospective analysis of a prospectively collected database from the Stenting and Angioplasty in NeuroThrombectomy (SAINT) consortium. Patients were included if thrombectomy had failed and they then underwent rescue emergency stenting. Patients treated with SES or BMS were compared using inverse probability of treatment weighting. The primary outcome was the final reperfusion as measured by the modified Thrombolysis in Cerebral Infarction (mTICI) Scale. Safety measures included rates of symptomatic intracranial hemorrhage, procedural complications, and 90-day mortality. Results A total of 328 patients were included. Baseline clinical and procedural characteristics were well balanced among both groups. The BMS group (n=127) had higher rates of successful reperfusion (94.5% vs 86.6%, aOR=4.23, 95% CI 1.57 to 11.37, P=0.004) and increased likelihood of higher degree of final reperfusion on the mTICI Scale (acOR=2.06, 95% CI 1.19 to 3.57, P=0.01) than the SES group (n=201). No difference in modified Rankin Scale shift (acOR=0.98, 95% CI 0.54 to 1.79, P=0.95), rates of mRS0-2 (26% vs 36%, aOR=0.93, 95% CI 0.46 to 1.88, P=0.83) and mRS0-3 (43% vs 50%, aOR=0.92, 95% CI 0.51 to 1.66, P=0.77) at 90 days were noted. Safety measures were comparable in both groups. Conclusion The present study demonstrates higher reperfusion rates with BMS than with SES in failed thrombectomy procedures that involved rescue stenting. No differences in hemorrhagic complications or clinical outcomes were noted. Further larger controlled studies are warranted.
AB - Background Previous studies have shown that when thrombectomy has failed, rescue intracranial stenting is associated with better clinical outcomes compared with failed reperfusion. However, comparative data regarding stent type are lacking. Objective To compare the procedural and clinical outcomes of balloon-mounted stents (BMS) with those of self-expandable stents (SES). Methods Retrospective analysis of a prospectively collected database from the Stenting and Angioplasty in NeuroThrombectomy (SAINT) consortium. Patients were included if thrombectomy had failed and they then underwent rescue emergency stenting. Patients treated with SES or BMS were compared using inverse probability of treatment weighting. The primary outcome was the final reperfusion as measured by the modified Thrombolysis in Cerebral Infarction (mTICI) Scale. Safety measures included rates of symptomatic intracranial hemorrhage, procedural complications, and 90-day mortality. Results A total of 328 patients were included. Baseline clinical and procedural characteristics were well balanced among both groups. The BMS group (n=127) had higher rates of successful reperfusion (94.5% vs 86.6%, aOR=4.23, 95% CI 1.57 to 11.37, P=0.004) and increased likelihood of higher degree of final reperfusion on the mTICI Scale (acOR=2.06, 95% CI 1.19 to 3.57, P=0.01) than the SES group (n=201). No difference in modified Rankin Scale shift (acOR=0.98, 95% CI 0.54 to 1.79, P=0.95), rates of mRS0-2 (26% vs 36%, aOR=0.93, 95% CI 0.46 to 1.88, P=0.83) and mRS0-3 (43% vs 50%, aOR=0.92, 95% CI 0.51 to 1.66, P=0.77) at 90 days were noted. Safety measures were comparable in both groups. Conclusion The present study demonstrates higher reperfusion rates with BMS than with SES in failed thrombectomy procedures that involved rescue stenting. No differences in hemorrhagic complications or clinical outcomes were noted. Further larger controlled studies are warranted.
KW - Angioplasty
KW - Balloon
KW - Stent
KW - Thrombectomy
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U2 - 10.1136/jnis-2024-022795
DO - 10.1136/jnis-2024-022795
M3 - Article
C2 - 39884852
AN - SCOPUS:85217140055
SN - 1759-8478
VL - 17
SP - e295-e302
JO - Journal of neurointerventional surgery
JF - Journal of neurointerventional surgery
IS - e2
ER -