{
  "abstract": "Introduction Underlying intracranial atherosclerotic disease (ICAD) remains the leading cause of 15-29% unsuccessful reperfusion cases following mechanical thrombectomy (MT) and is associated with higher mortality and poor neurological outcomes. Emergent adjunct intracranial stenting has been variably adopted to address residual stenosis or intraprocedural re-occlusion; however, high-quality comparative data remain limited. We evaluated the safety and efficacy of adjunct rescue stenting in patients with ICAD with acute vessel occlusion.Methods We performed a retrospective observational cohort study of consecutive adult patients undergoing MT for acute ischemic stroke at a tertiary academic center between April 2013 and November 2025. Patients with baseline modified Rankin Scale (mRS) 0-2 and angiographic evidence of ICAD (50-99% residual stenosis after thrombectomy or intraprocedural re-occlusion) were included. Patients were stratified into MT-alone and MT plus adjunct stenting (MT+stent) groups. The primary outcome was 90-day mRS shift analyzed using an ordinal logistic regression. Secondary outcomes included 90-day favorable functional outcome (mRS 0-2), successful reperfusion (final TICI ≥2b) and all-cause mortality, analyzed using generalized linear models with relative risks (RR), adjusted for age, sex, and baseline mRS. Safety endpoints included symptomatic intracranial hemorrhage (sICH) and periprocedural complications.Results A total of 106 patients met inclusion criteria. Atrial fibrillation was more prevalent in the MT-alone group (47.2% vs 22.6%, p=0.008), which also required more thrombectomy passes (2.28 vs 1.19, p<0.001). Adjunct stenting was independently associated with improved 90-day functional outcomes (median mRS 3 [IQR 1-4] vs 4 [IQR 3-6]; OR 0.56, 95% CI 0.15-0.96). Favorable functional outcome occurred more frequently in MT+stent (49.1%) compared with MT-alone (22.6%; RR 3.29, 95% CI 1.42-7.61). Successful reperfusion was significantly higher in MT+stent (88.7% vs 54.7%; RR 6.48, 95% CI 2.37-17.75). Ninety-day mortality was lower in the MT+stent group (15.1% vs 32.7%; RR 0.38, 95% CI 0.15-0.97). sICH occurred in two patients in the MT-alone group and none in the MT+stent group.Conclusion In patients with ICAD-related stroke, adjunct rescue stenting during MT was safe and associated with significantly improved reperfusion, functional outcome, and reduced mortality. These findings support a proactive endovascular strategy and provide meaningful inform regarding procedural decision-making in this high-risk population.Disclosures X. Yang: None. J. Thompson: None. S. Cruz-Flores: None. M. Moussavi: None. G. Rodriguez: None. A. Maud: None.Abstract O-011 Table 1",
  "authors": [
    {
      "affiliations": [
        "Neurology, Texas Tech University Health Science Center, El Paso, El Paso, TX"
      ],
      "name": "X Yang"
    },
    {
      "affiliations": [
        "Medical School, Texas Tech University Health Science Center, El Paso, El Paso, TX"
      ],
      "name": "J Thompson"
    },
    {
      "affiliations": [
        "Neurology, Texas Tech University Health Science Center, El Paso, El Paso, TX"
      ],
      "name": "S Cruz-Flores"
    },
    {
      "affiliations": [
        "Neurology, Texas Tech University Health Science Center, El Paso, El Paso, TX"
      ],
      "name": "M Moussavi"
    },
    {
      "affiliations": [
        "Neurology, Texas Tech University Health Science Center, El Paso, El Paso, TX",
        "Radiology, Texas Tech University Health Science Center, El Paso, El Paso, TX"
      ],
      "name": "G Rodriguez"
    },
    {
      "affiliations": [
        "Neurology, Texas Tech University Health Science Center, El Paso, El Paso, TX",
        "Radiology, Texas Tech University Health Science Center, El Paso, El Paso, TX"
      ],
      "name": "A Maud"
    }
  ],
  "title": "O-011 Adjunct emergent stenting during mechanical thrombectomy is safe and improves neurological functional outcome in patients with underlying ICAD",
  "uid": "bf2f670d-3bb5-5e99-9b33-6736c6ab5ada"
}