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Endovascular Thrombectomy in Medium and Distal Vessel Occlusions: A Focused Guideline From the Society of Vascular and Interventional Neurology Guidelines and Practice Standards Committee.

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A Novel Technique of Rescuing Capsulorhexis Radial Tear-out using a Cystotome
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RESCUE-ICAS: Rationale and Study Design.

Eyad Almallouhi1,2, Adam de Havenon3, Khaled Asi4

  • 1Department of Neurosurgery Medical University of South Carolina Charleston SC.

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|January 26, 2026
PubMed
Summary
This summary is machine-generated.

Mechanical thrombectomy (MT) failure is common, often due to intracranial stenosis with large-vessel occlusion (ICAS-LVO). The RESCUE-ICAS registry investigates ICAS-LVO prevalence and rescue therapy effectiveness.

Keywords:
intracranial stenosislarge vessel occlusionmechanical thrombectomy

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Area of Science:

  • Neurology
  • Interventional Neuroradiology
  • Vascular Neurology

Background:

  • Mechanical thrombectomy (MT) failure rates range from 10% to 20%.
  • Residual intracranial stenosis (ICAS), often atherosclerotic, is a key cause of MT failure.
  • Intracranial stenosis with large-vessel occlusion (ICAS-LVO) requires further understanding and clear management strategies.

Purpose of the Study:

  • To enhance understanding of ICAS-LVO prevalence.
  • To evaluate the safety and efficacy of various rescue therapies for ICAS-LVO.
  • To gather data for future randomized controlled trials (RCTs) in ICAS-LVO management.

Main Methods:

  • RESCUE-ICAS is a prospective, multicenter, international registry.
  • Enrolls patients with ICAS-LVO who have undergone MT.
  • Collects comprehensive baseline, procedural, and postprocedural data.

Main Results:

  • Data collection includes demographics, clinical and radiographic variables, and MT procedural details.
  • Rescue therapy decisions are interventionist-dependent.
  • Key outcomes measured are successful recanalization, symptomatic intracranial hemorrhage, 90-day modified Rankin Scale score, and mortality.

Conclusions:

  • Optimal treatment strategies for ICAS-LVO during MT are not well-established.
  • The RESCUE-ICAS registry provides crucial data for designing future RCTs.
  • This study aims to improve the management of patients with ICAS-LVO.