Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2026 Jan 5;47(1):73-78.
doi: 10.3174/ajnr.A8918.

Safety of Emergent Intracranial Stenting after Thrombolysis: A Multicenter Matched Analysis

Andrea M Alexandre  1 , Luca Scarcia  2 , Arturo Consoli  3 , Wen Sun  4 , Yingjie Xu  4 , Xianjun Huang  5 , Charlotte Chung  6 , Alessandro Sgreccia  3 , Mohamad Abdalkader  7 , Nicola Limbucci  8 , Alessandro Pedicelli  1 , Davide De Leoni  9 , Maria P Ganimede  10 , Chiara Gaudino  11 , Riccardo Russo  12 , Chrysanthi Papagiannaki  13 , Roberta Partesano  14 , Nicolò Mandruzzato  15 , Joseph D Gabrieli  16 , Pietro Panni  17 , Andrea Zini  18 , Frédéric Clarençon  19 , Eytan Raz  6 , Thanh N Nguyen  7 , Aldobrando Broccolini  20   21 ; collaborators of the emergent Intra-Cranial Artery Stenting (eICAS) International Study Group; Collaborators of the emergent Intra-Cranial Arterial Stenting (eICAS) international study group
Collaborators, Affiliations
Multicenter Study

Safety of Emergent Intracranial Stenting after Thrombolysis: A Multicenter Matched Analysis

Andrea M Alexandre et al. AJNR Am J Neuroradiol. .

Abstract

Background and purpose: In patients with acute large vessel occlusion (LVO) of the MCA and underlying intracranial artery stenosis (ICAS), rescue stenting (RS) has been associated with better angiographic outcomes and higher rates of functional independence compared with mechanical thrombectomy (MT) alone. However, uncertainty exists regarding safety of RS in patients at higher risk for intracranial bleeding. The primary aim of this retrospective multicenter study was to compare safety outcomes between patients with acute ICAS-LVO of the MCA who underwent MT and RS with or without prior intravenous thrombolysis (IVT). Efficacy outcomes were assessed as a secondary aim.

Materials and methods: We screened the prospective databases of 26 stroke centers across Europe, the United States, and China for consecutive patients with acute MCA ICAS-LVO who received RS. Patients were divided into 2 groups based on prior administration of IVT: IVT/RS and no-IVT/RS. Propensity score matching (PSM), based on a set of covariates that also included periprocedural antiplatelet therapies, was used to estimate the effect of IVT treatment. Primary safety outcomes were the occurrence of symptomatic intracranial hemorrhage (sICH) and 90-day mortality.

Results: After PSM, 52 pairs of patients were available for analysis. No significant differences were observed between the 2 groups regarding rates of sICH (11.5% in IVT/RS group versus 9.6% in no-IVT/RS group; OR = 1.2; 95% CI, 0.4-4.3; P = .75) and 90-day mortality (14.3% in the IVT/RS group versus 11.7% in the no-IVT/RS group; OR = 1.3; 95% CI, 0.4-4.2; P = .71). There were also no significant differences in the occurrence of parenchymal hemorrhage types 1 and 2, successful recanalization rates, and 90-day functional outcome.

Conclusions: The safety of RS in ICAS-LVO is not significantly affected by prior IVT administration. Furthermore, IVT does not result in improved recanalization and clinical outcome. These findings should be interpreted with caution and require validation through future randomized controlled studies.

PubMed Disclaimer

References

    1. Goyal M, Menon BK, Van Zwam WH, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet 2016;387:1723–31 10.1016/S0140-6736(16)00163-X - DOI - PubMed
    1. Kim BM. Causes and solutions of endovascular treatment failure. J Stroke 2017;19:131–42 10.5853/jos.2017.00283 - DOI - PMC - PubMed
    1. Jia B, Ren Z, Mokin M, et al. Current status of endovascular treatment for acute large vessel occlusion in China: a real-world nationwide registry. Stroke 2021;52:1203–12 10.1161/STROKEAHA.120.031869 - DOI - PubMed
    1. Kim JS, Kang DW, Kwon SU. Intracranial atherosclerosis: incidence, diagnosis and treatment. J Clin Neurol 2005;1:1–7 10.3988/jcn.2005.1.1.1 - DOI - PMC - PubMed
    1. Al Kasab S, Almallouhi E, Jumaa MA, et al. Outcomes of adjunct emergent stenting versus mechanical thrombectomy alone: the RESCUE-ICAS registry. Stroke 2025;56:390–400 10.1161/STROKEAHA.124.049038 - DOI - PubMed

Publication types

LinkOut - more resources