Frontiers in Neurology (Sep 2021)
Intracranial Stenting as Rescue Therapy After Failure of Mechanical Thrombectomy for Basilar Artery Occlusion: Data From the ANGEL-ACT Registry
- Gang Luo,
- Gang Luo,
- Feng Gao,
- Feng Gao,
- Xuelei Zhang,
- Xuelei Zhang,
- Xuelei Zhang,
- Baixue Jia,
- Baixue Jia,
- Xiaochuan Huo,
- Xiaochuan Huo,
- Raynald Liu,
- Raynald Liu,
- Man Sum Chi,
- Man Sum Chi,
- Man Sum Chi,
- Gaoting Ma,
- Gaoting Ma,
- Guangge Peng,
- Guangge Peng,
- Jingyu Zhang,
- Jingyu Zhang,
- Zhongqi Qi,
- Zhongqi Qi,
- Xu Guo,
- Xu Guo,
- Xu Guo,
- Bin Han,
- Bin Han,
- Bin Han,
- Xu Tong,
- Xu Tong,
- Bo Wang,
- Bo Wang,
- Ligang Song,
- Ligang Song,
- Lian Liu,
- Lian Liu,
- Zijun He,
- Zijun He,
- Dapeng Mo,
- Dapeng Mo,
- Ning Ma,
- Ning Ma,
- Xuan Sun,
- Xuan Sun,
- Ming Yang,
- Ming Yang,
- Zhongrong Miao,
- Zhongrong Miao
Affiliations
- Gang Luo
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Gang Luo
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Feng Gao
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Feng Gao
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Xuelei Zhang
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Xuelei Zhang
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Xuelei Zhang
- Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
- Baixue Jia
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Baixue Jia
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Xiaochuan Huo
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Xiaochuan Huo
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Raynald Liu
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Raynald Liu
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Man Sum Chi
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Man Sum Chi
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Man Sum Chi
- Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong, SAR China
- Gaoting Ma
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Gaoting Ma
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Guangge Peng
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Guangge Peng
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Jingyu Zhang
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Jingyu Zhang
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Zhongqi Qi
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Zhongqi Qi
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Xu Guo
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Xu Guo
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Xu Guo
- Department of Neurology, Shanxi Provincial People's Hospital, Taiyuan, China
- Bin Han
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Bin Han
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Bin Han
- Department of Interventional Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Xu Tong
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Xu Tong
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Bo Wang
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Bo Wang
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Ligang Song
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Ligang Song
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Lian Liu
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Lian Liu
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Zijun He
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Zijun He
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Dapeng Mo
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Dapeng Mo
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Ning Ma
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Ning Ma
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Xuan Sun
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Xuan Sun
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Ming Yang
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Ming Yang
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Zhongrong Miao
- Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Zhongrong Miao
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- DOI
- https://doi.org/10.3389/fneur.2021.739213
- Journal volume & issue
-
Vol. 12
Abstract
Background and Purpose: Studies on rescue therapy for acute posterior circulation stroke due to basilar artery occlusion (BAO) are limited in the modern era of mechanical thrombectomy (MT). The aim of this study was to evaluate the safety and efficacy of rescue stenting (RS) following MT failure in patients with BAO.Methods: Data were collected from the Endovascular Treatment Key Technique and Emergency Work Flow Improvement of Acute Ischemic Stroke (ANGEL-ACT) prospective registry in China. Patients who underwent MT for BAO with failure of recanalization were enrolled in this study. The patients were divided into the RS and non-RS groups. Clinical and laboratory findings, procedural details, and clinical outcomes were compared between the two groups.Results: Overall, 93 patients with acute BAO were analyzed. The RS group included 81 (87.1%) patients, and the non-RS group included 12 patients. A modified treatment in cerebral infarction (mTICI) score of 2b/3 was achieved in 75 (92.6%) patients in the RS group. Compared with the non-RS group, the RS group had a significantly higher rate of successful recanalization and favorable clinical outcomes (modified Rankin Scale score at 90 days post-procedure, 0–3: 16.7 vs. 51.9%, respectively; P = 0.023) without an increase in the rate of symptomatic intracranial hemorrhage and a significantly lower mortality rate (58.3 vs. 18.5%, respectively; P = 0.006). Furthermore, the use of a glycoprotein IIb/IIIa inhibitor improved the rate of recanalization of the target artery without increasing the rate of symptomatic intracranial hemorrhage.Conclusions: Permanent stenting appears to be a feasible rescue modality when MT fails and might provide functional benefits in patients with acute ischemic stroke due to BAO.
Keywords
- basilar artery occlusion
- mechanical thrombectomy
- rescue stenting
- posterior circulation
- acute stroke
- recanalization
