Abstract Details

Title Safety Profile of Rescue Stenting Following Thrombectomy for Acute Basilar Artery Occlusion – PC SEARCH Registry Analysis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P7 - Poster Session 7 (8:00 AM-9:00 AM)

Poster/Presentation
Number 6-002

Objective Our aim was to determine efficacy and safety profile of rescue stenting following thrombectomy in a cohort of patients with acute basilar artery occlusion

Background Recent randomized controlled trials demonstrated clinical benefit of mechanical thrombectomy for acute basilar artery occlusion. Approximately 10% of patients undergoing mechanical thrombectomy require rescue angioplasty/ stenting due to residual underlying stenosis to main successful reperfusion

Design/Methods PC-SEARCH is a multi-centered retrospective registry of consecutive acute BAOs treated with thrombectomy with contributions from eight high-volume centers across the United States from July 2015 – December 2021. Patients were included in this registry if they received mechanical thrombectomy or intra-arterial thrombolysis within 24 hours of last seen well. Good clinical outcome was defined as 3 months mRS ≤ 3. Multivariate logical regression models were used to identify predictors of good clinical outcomes in patients who received rescue stenting.

Results Total of 336 patients were included in the analyses, of those, fifty two (6.5%) received rescue stenting. There was no difference in age, admission NIHSS or PC ASPECTS score between the stenting and non stenting groups. Good recanalization (≥TICI 2b) was achieved in 82% in the non-stent group vs 91% in the stent group, P=0.103. Forty-five percent of patients reached mRS ≤3 with overall mortality rate of 41.4% at 90 days in the non-stent group vs 44.2% in the stenting group. Similar rates of sICH were noted between the two groups (0% in rescue stenting vs. 5.4) in MT only group, p value 0.089). Multivariate analysis demonstrated similar rates of good outcome (OR 1.26, CI 0.53 - 1.964; p = 0.95) among the rescue stenting compared to non stenting group.

Conclusions In patients with acute basilar occlusion, rescue stenting due to underlying residual stenosis, stenting appears to be safe with similar rates of complications and favorable outcomes compared to no stenting group.

Authors/Disclosures
Ehad Afreen, MD (Promedica Physicians Group Neurology) PRESENTER	Dr. Afreen has nothing to disclose.
Adam T. Mierzwa, MD (Promedica)	Dr. Mierzwa has nothing to disclose.
Syed F. Zaidi, MD (ProMedica Stroke Network)	Dr. Zaidi has nothing to disclose.
Nameer Aladamat, MBBS (The University of Toledo)	Dr. Aladamat has nothing to disclose.
Khaled Gharaibeh, MD (ProMedica Neurosciences Center)	Dr. Gharaibeh has nothing to disclose.
Ashley Nelson, DO (University of Rochester Medical Center/Strong Memorial Hospital)	Dr. Nelson has nothing to disclose.
Santiago Ortega Gutierrez, MD (University of Iowa)	Dr. Ortega Gutierrez has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for stryker. Dr. Ortega Gutierrez has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for medtronic. Dr. Ortega Gutierrez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. The institution of Dr. Ortega Gutierrez has received research support from stryker. The institution of Dr. Ortega Gutierrez has received research support from Medtronic. The institution of Dr. Ortega Gutierrez has received research support from Methinks. The institution of Dr. Ortega Gutierrez has received research support from NIH. The institution of Dr. Ortega Gutierrez has received research support from PCORI.
Mudassir Farooqui, MD	Dr. Farooqui has nothing to disclose.
Juan A. Vivanco-Suarez, MD	Mr. Vivanco-Suarez has nothing to disclose.
Ashutosh P. Jadhav, MD, FAAN (Barrow Neurological Institute)	Dr. Jadhav has nothing to disclose.
Shashvat Desai, MD (University of Pittsburgh Medical Center)	Dr. Desai has nothing to disclose.
Gabor Toth, MD (Cleveland Clinic Foundation)	Dr. Toth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Dynamed. Dr. Toth has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. Dr. Toth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kaneka. Dr. Toth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Penumbra.
Anas M. Alrohimi, MD (University of Alberta)	Dr. Alrohimi has nothing to disclose.
Thanh Nguyen, MD	Dr. Nguyen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Vesalio. Dr. Nguyen has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. Dr. Nguyen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Avania. Dr. Nguyen has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AHA. The institution of Dr. Nguyen has received research support from Boston Medical Center. The institution of Dr. Nguyen has received research support from Society of Vascular and Interventional Neurology.
Piers Klein	Mr. Klein has nothing to disclose.
Mohamad Abdalkader (Boston Medical Center Deptartment Of Radiology)	Mohamad Abdalkader has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Nirav Vora, MD	No disclosure on file
Mouhammad A. Jumaa, MD (ProMedica Stroke Network)	Dr. Jumaa has nothing to disclose.
Sami Alkasab, MD (MUSC)	Dr. Alkasab has nothing to disclose.

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