ArticleAJNR. American journal of neuroradiology2021
Refractory Stroke Thrombectomy: Prevalence, Etiology, and Adjunctive Treatment in a North American Cohort.
Article in AJNR. American journal of neuroradiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Rescue intracranial stenting for acute ischemic stroke after the failure of mechanical thrombectomy: A systematic review, meta-analysis, and trial sequential analysis.Frontiers in neurology · 2023Pooled it
- Safety and Efficacy of Cangrelor in Acute Stroke Treated with Mechanical Thrombectomy: Endovascular Treatment of Ischemic Stroke Registry and Meta-analysis.AJNR. American journal of neuroradiology · 2022Pooled it
- A prediction model for functional outcome following rescue therapy in patients with acute ischemic stroke undergoing endovascular treatment.Annals of medicine · 2026Article
- Effect Modification of Rescue Stenting in ICAS-Related Middle Cerebral Artery Occlusion: The Role of Thrombectomy Failure, Stenosis Severity, and ASPECTS.Translational stroke research · 2026Article
- Clinical outcome after rescue intracranial stenting: a comparison of the ACCLINO flex and the CREDO heal stenting platforms after failed mechanical thrombectomy.Neuroradiology · 2026Article
- Impact of Stenting with Angioplasty and MTICI 2c-3 Recanalization On Outcome in Acute MCA Occlusion with Underlying Stenosis.Clinical neuroradiology · 2026Article
- Real-world experience of the large 6 × 50 mm Aperio Stent-retriever: evaluation of effectiveness and safety.Neuroradiology · 2026Article
- How Much Is ICAD Required to Justify Rescue Stenting?Clinical neuroradiology · 2025Article
- Refractory Thrombectomy: Incidence and Related Factors in a Third-Level Stroke Treatment Center.Journal of clinical medicine · 2025Article
- Histopathological composition of thrombus material in a large cohort of patients with acute ischemic stroke: a study of atypical clots.Frontiers in neurology · 2025Article
- Iatrogenic arterial vasospasm during mechanical thrombectomy requiring treatment with intra-arterial nimodipine might be associated with worse outcomes.European journal of neurology · 2024Observational
- Predictors and Outcomes of Excellent Recanalization Versus Successful Recanalization After Thrombectomy in Proximal and Distal Medium Vessel Occlusion Strokes: A Multinational Study.Stroke (Hoboken, N.J.) · 2024Article
- Association between procedural time and outcome in unsuccessful mechanical thrombectomy for acute ischemic stroke: analysis from the Italian Registry of Endovascular Treatment in Acute Stroke.Journal of neurology · 2024Article
- Rescue Stenting for Failed Mechanical Thrombectomy in Acute Ischemic Stroke: Systematic Review and Meta-analysis.Stroke (Hoboken, N.J.) · 2023Article
- Review
- Crossing double stent retriever technique for refractory terminal internal carotid artery occlusion.Radiology case reports · 2022Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeAcute stroke intervention refractory to mechanical thrombectomy may be due to underlying vessel wall pathology including intracranial atherosclerotic disease and intracranial arterial dissection or recalcitrant emboli. We studied the prevalence and etiology of refractory thrombectomy, the safety and efficacy of adjunctive interventions in a North American-based cohort. MATERIALS AND
methodsWe performed a multicenter, retrospective study of refractory thrombectomy, defined as unsuccessful recanalization, vessel reocclusion in <72 hours, or required adjunctive antiplatelet glycoprotein IIb/IIIa inhibitors, intracranial angioplasty and/or stenting to achieve and maintain reperfusion. Clinical and imaging criteria differentiated etiologies for refractory thrombectomy. Baseline demographics, cerebrovascular risk factors, technical/clinical outcomes, and procedural safety/complications were compared between refractory and standard thrombectomy groups. Multivariable logistic regression analysis was performed to determine independent predictors of refractory thrombectomy.
resultsRefractory thrombectomy was identified in 25/302 cases (8.3%), correlated with diabetes (44% versus 22%,
conclusionsRefractory stroke thrombectomy is encountered in <10% of cases, independently associated with diabetes, and related to underlying vessel wall pathology (intracranial atherosclerotic disease and/or intracranial arterial dissection) or, less commonly, recalcitrant emboli. Emergent salvage interventions with glycoprotein IIb/IIIa inhibitors or intracranial angioplasty and/or stenting are safe and effective adjunctive treatments.
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