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Updated: Jan 28, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Outcomes After Intracranial Rescue Stenting for Acute Ischemic Stroke.

Christine Tschoe1, Stephanie Coffman2, Carol Kittel2

  • 1Baylor College of Medicine Houston TX.

Stroke (Hoboken, N.J.)
|January 26, 2026
PubMed
Summary
This summary is machine-generated.

Rescue stenting (RS) after failed mechanical thrombectomy (MT) significantly improves outcomes for emergent large vessel occlusion patients. This approach offers better results than conservative treatment without substantially increasing hemorrhage risk in eligible patients.

Keywords:
acute ischemic strokeemergent large vessel occlusionendovascular therapyintracranial stentingmechanical thrombectomyrescue stentingthrombectomy failure

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Area of Science:

  • Neurology
  • Interventional Neuroradiology
  • Vascular Surgery

Background:

  • Mechanical thrombectomy (MT) is a standard treatment for acute ischemic stroke.
  • Failed recanalization after MT necessitates alternative strategies.
  • The efficacy of rescue stenting (RS) following failed MT is not well-established.

Purpose of the Study:

  • To evaluate the outcomes of intracranial rescue stenting (RS) in patients with emergent large vessel occlusion after failed mechanical thrombectomy (MT).
  • To compare RS outcomes against the natural history of persistent large vessel occlusion.
  • To assess complications associated with RS.

Main Methods:

  • Retrospective analysis of patients who underwent RS after failed MT (2014-2019).
  • Comparison with historical control groups from major MT trials (MR CLEAN, ESCAPE, DAWN) based on inclusion/exclusion criteria.
  • Assessment of reperfusion rates and 90-day functional outcomes (modified Rankin Scale).

Main Results:

  • RS achieved reperfusion (Thrombolysis in Cerebral Infarction ≥2B) in 85.8% of cases.
  • Good 90-day outcomes (mRS 0-2) were observed in 33.9% of RS patients.
  • RS patients meeting trial criteria had significantly better outcomes compared to MR CLEAN (40.8% vs 19%) and DAWN (27% vs 13%) medical arms.
  • No significant increase in symptomatic intracranial hemorrhage compared to MR CLEAN, but increased compared to DAWN.

Conclusions:

  • Rescue stenting (RS) after failed mechanical thrombectomy (MT) significantly improves outcomes in eligible patients.
  • RS offers a superior alternative to conservative management following failed MT.
  • Hemorrhagic complications were not significantly increased in early thrombectomy windows, with outcomes comparable to successful MT.