Search Results for: Utilizzo degli stent-retriever nell’ictus ischemico acuto

‘Stato gold’ nell’ambito del programma ‘Eso-Angels Awards

In a clinical trial of patients with post-thrombotic syndrome, stent patency rates were comparable with or without add-on aspirin.

We are delighted that Fritzsche et al have expressed an interest in our randomised trial investigating the effects of endoluminal radiofrequency ablation (RFA) on survival and stent patency in cholangiocarcinoma (CCA) and pancreatic ductal adenocarcinoma (PDAC) patients.1 2 We fully agree that plastic stents are likely to exhibit shorter patency in patients with CCA. The low patency in our small subgroup of patients treated with RFA and plastic stents (n=5) was due to the development of acute cholangitis within 2 weeks of the index procedures, requiring reintervention in three of these patients. We used plastic stents only in situations where anatomical considerations did not allow for the safe and reliable use of metal stents. We believe that this decision was necessary and fully justified in this more susceptible subset of patients. Interestingly, we observed no difference in stent patency in PDAC patients, even though almost all…

Circulation, Ahead of Print. BACKGROUND:The optimal coronary stenting technique for true left main bifurcation lesions is uncertain. EBC MAIN (European Bifurcation Club Left Main Trial) aimed to evaluate clinical outcomes of a stepwise provisional strategy compared with a systematic dual-stent approach.METHODS:EBC MAIN was a randomized, investigator-initiated, open-label, multicenter, parallel-group trial conducted across 35 hospitals in 11 European countries. A total of 467 participants undergoing percutaneous coronary intervention for unprotected true left main bifurcation lesions were randomly assigned to the stepwise provisional strategy (n=230) or an upfront dual-stent approach (n=237). The mean (SD) age was 71 (10) years and 23% of participants were women. The primary end point was a composite of major adverse cardiac events, defined as all-cause mortality, all myocardial infarction, or clinically driven target lesion revascularization. Events were adjudicated by an independent clinical events committee and all analyses were by the intention-to-treat principle.RESULTS:At 3 years, the primary end point occurred in 54 of 230 (23.5%) stepwise provisional and 70 of 237 (29.5%) dual-stent patients (hazard ratio, 0.75 [95% CI, 0.53–1.07];P=0.11). There was no significant difference in all-cause mortality (10.0% versus 13.1%) or myocardial infarction (12.2% versus 11.0%). However, target lesion revascularization was significantly lower in the stepwise provisional group (8.3% versus 15.6%; hazard ratio, 0.50 [95% CI, 0.29–0.86];P=0.013). In this population, the mean side vessel diameter by quantitative angiography was 2.9 mm, and median side vessel lesion length was 5 mm. Significant interactions were identified between the assigned bifurcation strategy and both side vessel diameter and lesion length with respect to the primary outcome (P=0.009 andP=0.005, respectively), with smaller vessels (

Stroke, Volume 56, Issue Suppl_1, Page A80-A80, February 1, 2025. Introduction:Although flow diverters (FD) are a long-established treatment-option for brain aneurysms, the evidence of data associated with therapy success is still based on relatively small heterogeneous studies. Recent data from a large prospective registry with highly standardized, independent adjudication might provide more insights.Methods:The INSPIRE-A registry is a prospective, single arm study of brain aneurysms treated with commercially available Medtronic devices, including latest FD technology with surface modifications. The registry collects data from 70 centers in 21 countries. Results are adjudicated by an independent Imaging Core Laboratory and a Clinical Events Committee. The association of patient characteristics, aneurysm details, and procedural variables with aneurysm occlusion (Raymond–Roy occlusion classifications [RROC I]), and in-stent stenosis at 1 year follow-up (FU) were tested using multivariable logistic regression analysis.Results:786 patients were analyzed. The median age was 55 years (IQR, 46-64) and 79.6% (626) were female. Most frequently, aneurysms were in the anterior circulation (89.8 %, 706) with highest rates of ICA-Aneurysms (75.3%, 592) in the C6 (52.7%, 312/592). Median diameter and neck width of aneurysms were 7.2 mm (IQR, 5-11) and 6.5 mm (IQR, 4-10), respectively. 91.7% (719) of aneurysms were saccular. The Pipeline Flex with Shield technology (Medtronic, Irvine CA) device was deployed in 58% (456), the Pipeline Vantage with Shield technology (Medtronic, Irvine CA) device in 42% (330). Adjunctive coiling was used in 19.8% (156). At 1 year FU, RROC I was observed in 74.3% (584) of cases. In multivariable analysis, increasing age (OR, 0.97, 95% CI, 0.96-0.99; p

Stroke, Volume 56, Issue Suppl_1, Page ATMP82-ATMP82, February 1, 2025. Introduction:Aspiration and stent retriever thrombectomy are the primary approaches for endovascular management of posterior circulation stroke. However, the optimal first-line choice of surgical technique remains unclear. This study aims to conduct a systematic review and meta-analysis comparing first-line aspiration with stent retriever thrombectomy in terms of recanalization rates, complications, and clinical outcomes.Methodology:This systematic review and meta-analysis followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Databases searched included PubMed, Embase, Web of Science, Cochrane, and ClinicalTrials.gov, focusing on studies comparing the efficacy and safety of first-line aspiration versus stent retriever thrombectomy for posterior circulation stroke. Data analysis was performed using RevMan version 5.4.1, with statistical significance set at p < 0.05.Result:A total of 21 studies, including 2,521 patients, were analyzed. First-line aspiration demonstrated a significant advantage in terms of successful recanalization (OR = 1.36; 95% CI: 1.04–1.76; p = 0.002) and complete recanalization (OR = 1.41; 95% CI: 0.91–2.20; p = 0.03), both favoring aspiration over the stent retriever technique. Additionally, first-line aspiration was associated with a significantly lower overall complication rate (OR = 0.58; 95% CI: 0.40–0.85; p = 0.005) and a shorter procedural time (SMD = -0.60; 95% CI: -0.81 to -0.40; p < 0.005). However, there were no statistically significant differences between the two techniques in the first pass effect (OR = 1.41; 95% CI: 0.95–2.09; p = 0.09), the need for rescue therapy (OR = 1.01; 95% CI: 0.71–1.44; p = 0.96), 90-day all-cause mortality (OR = 0.95; 95% CI: 0.71–1.27; p = 0.72), and 90-day favorable functional outcome (OR = 1.17; 95% CI: 0.97–1.41; p = 0.11).Conclusion:This meta-analysis suggests that first-line aspiration may offer advantages over stent retrievers for posterior circulation stroke, particularly in terms of recanalization success and procedural safety. However, no significant differences were observed in key clinical outcomes such as mortality and favorable recovery.

Stroke, Volume 56, Issue Suppl_1, Page ATMP76-ATMP76, February 1, 2025. Background and Purpose:In randomized trials, carotid artery stent (CAS) may have higher risk of periprocedural risk compared with carotid endarterectomy (CEA) if performed within the first 7 days after the onset of symptoms.Methods:We analyzed the data from Carotid Revascularization Endarterectomy versus Stenting Trial (CREST). The time interval between the most recent qualifying ischemic event and CAS/CEA procedure was divided in four strata: 1-7 days, 8-14 days, 15-30 days and >30 days. We analyzed the effect of time interval strata between most recent qualifying ischemic event and procedure and procedure type (CEA versus CAS) on peri-procedural stroke and/or death after adjusting for age, gender, symptomatic status and initial severity of stenosis (≥70% versus 30 days (CAS 7.8% versus CAE 4.3%, p=0.12), after the most recent qualifying event. In the multivariate analysis, patients who underwent CAS had higher rate of peri-procedural stroke and/or death (odds ratio [OR] 2.36, 95% confidence interval [CI] 1.25- 4.66) but timing of procedure were not associated with higher rate of peri-procedural stroke and/or death after adjustment for potential confounders. The interaction between procedure type and timing of procedure was not significant. The rate of peri-procedural stroke and/or death was significantly higher in CAS patients who received clopidogrel bolus (without 48-hour maintenance dose) among patients treated 7 days or less after the qualifying event compared with those undergoing CEA (6.6% versus 0%, p=0.012) but was not different between CAS patients who received 48 hours of clopidogrel maintenance and those undergoing CEA (0% versus 0%).Conclusions:The higher rate of peri-procedural stroke and/or death seen with CAS (compared with CEA) within the first 7 days may be attributed to factors such as inadequate pre-procedure antiplatelet medication use. The results of CAS and CEA may become comparable within the first 7 days after the qualifying ischemic event with use of newer generation P2Y12 platelet inhibitors that achieve rapid antiplatelet inhibition.

Stroke, Volume 56, Issue Suppl_1, Page ATMP84-ATMP84, February 1, 2025. Introduction:Complete reperfusion (TICI 2c/3) with the fewest number of passes remains the target for EVT techniques, but at present, rates remain relatively low. Prior studies have demonstrated that switching techniques between passes may improve rates of reperfusion. Here we assess the efficacy of technique switching after the first pass failed reperfusion in a large multi-center cohort.Methods:All consecutive patients treated with EVT from 12 centers across the US were prospectively collected between 10/2018 – 12/2021 (SVIN Registry). Patients were included if they underwent EVT for occlusion of the M1 or ICA-T. Exclusion criteria included incomplete data. EVT technique was categorized as Stent-Retriever (SR), Contact Aspiration (CA), or a Combined Technique (CT). The primary outcome was the likelihood of achieving TICI 2c/3 with or without switching the thrombectomy technique and was determined using multivariable logistic regression adjusted for the use of balloon guide catheter, occlusion location, age, and co-morbid medical conditions.Results:Among 2,891 patients in the SVIN registry included in this analysis, the median age was 69 years [IQR, 58-80], 49.9% were female and median NIHSS was 17 [IQR, 12-22]. Occlusion location was ICA-T in 18.4% and M1 in 81.6%. As shown in Figure 1a, for patients with ICA-T occlusions, first-pass TICI 2c/3 occurred in 32.7% with SR, 23% with CA, and 31.2% with CT. As shown in Figure 1b, for patients with M1 occlusions, first-pass TICI 2c/3 occurred in 37.7% with SR, 35.9% with CA, and 35.4% with CT. Switching from CA to SR or CT for the 2nd pass was associated with increased point estimates of 2nd pass TICI 2c/3 for patients with ICA-T occlusions (27% vs 12%, second pass SR vs. second pass CA, p=0.06). In multivariable logistic regression, odds of TICI 2c/3 were significantly greater (OR 3.7, CI 95% [1.1 – 12.4]) after switching to SR or CT after a failed first pass with CA in patients with ICA-T occlusion.Conclusions:Switching from CA to SR-based techniques was associated with improvement in TICI 2c/3 reperfusion rates among patients with Internal Carotid Artery Terminus occlusions.

Stroke, Volume 56, Issue Suppl_1, Page A71-A71, February 1, 2025. Background:The ideal timing of carotid artery stenting (CAS) in symptomatic internal carotid artery (ICA) stenosis is partly determined by the risk of stroke and/or death associated with timing of the procedure. We evaluated the risk of stroke and/or death within 30 days of CAS, considering various time intervals from the last ipsilateral cerebral/retinal ischemic event, using real-world data.Methods:We analyzed the data for symptomatic patients with ICA stenosis who underwent CAS as part of the national Vascular Quality Initiative (VQI). We divided the time interval between ipsilateral cerebral/retinal ischemic events and CAS into 0-1 days, 2-7 days, 8-14 days, 15-30 days, and 31-180 days. We performed logistic regression analysis to identify the effect of time interval strata between ipsilateral cerebral/retinal ischemic event and CAS on the combined endpoint of any stroke or death within 30 days after adjusting for adjusting for age, gender, severity of stenosis strata, ipsilateral cerebral/retinal ischemic event type, pre-operative use of aspirin, and pre-operative use of antiplatelets other than aspirin.Results:The cohort consisted of 5431 patients, of which 308 patients underwent CAS 0-1 days, 1680 patients 2-7 days, 804 patients 8-14 days, 725 patients 15-30 days, and 1914 patients 31-180 days after the ipsilateral cerebral/retinal ischemic event. The proportion of patients who developed any stroke or death within 30 days was greatest in the shorter time interval group (3.2% for Days 0-1) and lowest in the longer interval group (1.7% for Days 31-180). The risk of any stroke or death within 30 days was significantly higher for those undergoing CAS within 0-1 days (odds ratio [OR] 1.99, 95% confidence interval [CI] 1.01-3.79) compared to those undergoing CAS 31-180 days after the ischemic event. The odds ratio was non significantly different for patients who underwent CAS 2-7 days (OR 1.36, 95% CI 0.87-2.16), 8-14 days (OR 1.47, 95% CI 0.85-2.51), and 15-30 days (OR 1.25, 95% CI 0.67-2.24) after ipsilateral cerebral/retinal ischemic event.Conclusion:Our results highlight the increased risk of stroke and/or death when CAS is performed within the first 2 days after ipsilateral cerebral/retinal ischemic event. Identifying the ideal relationship between timing of CAS after the non-disabling ischemic event and the combined risk of stroke or death within 30 days will allow appropriate triage of symptomatic ICA stenosis patient.

Stroke, Volume 56, Issue Suppl_1, Page AWP16-AWP16, February 1, 2025. Introduction:Currently, no level A evidence exists for the optimal rescue strategy for cases at high risk for re-occlusion following endovascular thrombectomy (EVT) in acute ischemic stroke. Glycoprotein IIb/IIIa inhibitors, which inhibit platelet aggregation and adhesion, show promise as adjunctive therapy, potentially yielding favorable outcomes, especially in residual stenosis cases.Methods:In this retrospective review study, we included patients aged ≥18 who underwent EVT at a comprehensive stroke center with TICI 2b or 2c outcome (admitted between 2019 – 2024), who were noted to have high-risk residual stenosis on angiography after EVT. We defined high-risk post-EVT stenosis as any stenosis with ≥50% lumen stenosis, associated dissection, re-occlusion during thrombectomy, and severe residual luminal irregularity. We excluded patients who had a clear contraindication to Eptifibatide, received a stent, or if the luminal stenosis was related to reactive vasospasm and any cases with TICI 0, 1, or TICI 3 scores.Results:Our sample size was 60 (51.7% male, 48.3% female, mean age 63.9). Mean National Institute of Health Stroke Scale (NIHSS) on admission was 16.6; 36.7% (n=22) received eptifibatide. The rate of re-occlusion was significantly lower in patients who received eptifibatide compared to those who did not (9.1% vs. 36.8%, p=0.032). There was no difference in pre-stroke modified Rankin scale (mRS), NIHSS on admission, mortality, discharge mRS, or 90-day mRS between these two groups, nor between patients who received intravenous thrombolysis (IVT) vs. those who did not. However, among the 16 patients who received IVT, those who also received eptifibatide had significantly lower mean discharge NIHSS (5.0 vs. 13.6, p=0.028), discharge mRS (1.3 vs. 4.5, p=0.009), and 90-day mRS (1.0 vs. 4.1, p=0.038) than those who did not. Ordinal logistic regression of discharge mRS and 90-day mRS in IVT recipients with vs. without eptifibatide usage also revealed significant odds of lower mRS at both timepoints with eptifibatide (OR 7.23, p=0.011 and OR 5.2, p=0.030 respectively).Conclusions:Eptifibatide use is associated with lower re-occlusion rates in patients with residual high-risk stenosis after EVT. Among IVT recipients with post-EVT residual stenosis, eptifibatide use is associated with improved discharge mRS, discharge NIHSS, and 90-day mRS. Given our limited sample size, these findings need to be evaluated further with larger Randomized Control Trials.

Stroke, Volume 56, Issue Suppl_1, Page A48-A48, February 1, 2025. Introduction:Supratentorial intracerebral hemorrhage (ICH) is a devastating stroke subtype with high mortality and morbidity, and hematoma clearance is a critical therapeutic target. Remote ischemic conditioning (RIC) with transient ischemia and reperfusion applied to the arm has been shown to accelerate hematoma resolution in both animal and clinical studies. The RICH-2 trial investigated whether RIC could improve the functional outcomes of patients with ICH.Methods:In this investigator-initiated, multicentre, prospective, randomized, sham-controlled, outcome-blinded parallel-group trial conducted in 20 centers in China, patients (age 18 to 80 years) with supratentorial ICH presenting within 24-48 h of ictus who do not need surgical therapy were randomly allocated (1:1, stratified by baseline NIHSS and clot size) to receive RIC or sham RIC for 7 consecutive days after randomization in addition to best medical management. The primary outcome was a score of 0-2 on the modified Rankin Scale at 90 days, analyzed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, NCT04657133.Results:Between Apr 22, 2021, and Oct 30, 2023, 458 patients were randomly assigned, with 229 in each group. 134 (29.3%) were women, and 324 (70.7%) were men, the median age was 58 years (IQR 51-68), the median NIHSS score was 9.0 (IQR 7.0-13.0), and the median hematoma volume was 12.6 mL (IQR 10.0-18.0). 156 (68.1%) of 229 patients in the RIC group and 163 (71.2%) of 229 patients in the sham group had a mRS score of 0-2 at 90 days (adjusted RR 0.98; 95% CI 0.88-1.09; adjusted p=0.69). Prespecified subgroup analysis showed a trend in favor of RIC in patients with clot size larger than 20 ml (RR 1.26, 95% CI 0.80-1.98, p=0.31). At 180-day follow-up, 169 (73.8%) of 229 patients receiving RIC and 175 (76.4%) of 229 patients receiving sham RIC achieved a mRS score of 0-2 (adjusted RR 0.98; 95% CI 0.89-1.08; adjusted p=0.64). Serious adverse events occurred in 16 (7.0%) of 229 patients receiving RIC and 12 (5.2%) of 229 patients receiving sham RIC (adjusted RR 1.29, 95% CI, 0.63-2.67, p=0.48). No important unexpected adverse events or side effects of RIC were observed.Conclusions:RIC did not improve the proportion of patients who achieved functional independence 90 days after ICH in patients who did not need surgical therapy. Further studies of RIC in this population should target patients with large clot sizes and address the RIC protocol.

Stroke, Volume 56, Issue Suppl_1, Page A39-A39, February 1, 2025. Background:The Food and Drug Administration (FDA) recommended that intracranial stenting (ICAS) not be performed within 7 days of qualifying cerebral ischemic event due to high rates of 1-month stroke and/or death observed with Wingspan intracranial stent placement in Stenting vs. Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial. However, a detailed analysis of the relationship between timing of ICAS and 1-month stroke and/or death has not been performed.Methods:We compared the rates of 1-month stroke and/or death associated with ICAS performed ≤7 days and those >7 days after qualifying cerebral ischemic event in patients recruited in two randomized multicenter trials (SAMMPRIS and Vitesse Intracranial Stent Study for Ischemic Stroke Therapy [VISSIT]. Both trials recruited patients aged ≥ 30 years and ≤ 80 years, who suffered from transient ischemic attack (TIA) or minor ischemic stroke related to high grade (70% to 99% in severity) stenosis in a major intracranial artery and used independent ascertainment for 1 month event rates. We performed logistic regression analysis to identify the effect of time interval strata between qualifying cerebral ischemic event and ICAS on 1-month stroke and/or death rate after adjusting for potential confounders.Results:A total of 108 and 170 patients underwent ICAS ≤7 days and >7 days after the qualifying cerebral ischemic event, respectively. Balloon expandable stent (BES) and self-expanding stent (SES) were used in 54 and 224 patients, respectively. The rates of 1-month stroke and death were 17 of 108 (15.7%) and 30 of 170 (17.6%) in patients treated ≤7 days and those >7 days after qualifying cerebral ischemic event, respectively (p=0.729). There was no difference in the 1-month stroke and/or death rate in patients who underwent ICAS ≤7 days and those >7 days after qualifying cerebral ischemic events (odds ratio 0.074, 95% confidence interval 0.28-2.41) after adjusting for age, gender, severity of stenosis strata, qualifying cerebral ischemic event type (TIA or minor ischemic stroke), and stent used (BES versus SES).Conclusions:We did not observe any increased risk of 1-month stroke and/or death in patients who underwent ICAS ≤7 days and those >7 days after the qualifying cerebral ischemic event. Delaying the ICAS according to current FDA recommendations may not be necessary when ICAS is indicated.

Stroke, Volume 56, Issue Suppl_1, Page A41-A41, February 1, 2025. Introduction:Current guidelines do not support the use of stenting for severe symptomatic intracranial atherosclerotic disease (ICAD) over maximal medical therapy (MMT) as first line treatment. This is largely due to the Stenting and Aggressive Medical Management Therapy for Preventing Recurrent Stroke in Intracranial Arterial Stenosis (SAMMPRIS) trial results which featured a high periprocedural stroke rate. In this study, we examined the rates of ischemic stroke in the territory of the qualifying artery (SIT) periprocedurally as well as over time between MMT alone and stent+MMT.Methods:The primary outcome of interest was SIT. Periprocedural stroke was defined as

Stroke, Volume 56, Issue Suppl_1, Page AWP43-AWP43, February 1, 2025. Objective:Recanalized aneurysms may still recanalize despite a second coiling to prevent rupture. Factors related to recanalization following a second coiling for recanalized aneurysms have not yet been fully explored. This study examined a large multicenter dataset accumulated over a 20-year period to identify factors related to major recanalization following a second coiling for recanalized aneurysms.Methods:A total of 185 patients with 188 aneurysms who underwent second coiling for saccular unruptured cerebral aneurysms at three institutions between November 2003 and December 2023 were retrospectively reviewed. Patients were categorized into a group with major recanalization (R group) and a group without major recanalization (NR group). To identify factors related to major recanalization, clinical, anatomic, and procedural factors were comparable between groups by multivariate logistic regression analysis and stepwise selection.Results:During the follow-up period (mean, 62.3 ± 51.2 months), 72 (38.3%) of 188 recanalized aneurysms developed major recanalization. Compared with the NR group, the R group had significantly larger aneurysm size, neck size, and aneurysm volume at initial coiling and significantly lower rates of stent-assisted coiling, use of an intermediate catheter, and complete occlusion at second coiling. Stepwise multivariate logistic regression analysis identified neck size at initial coiling (odds ratio [OR] 1.17; 95% confidence interval [CI] 1.03–1.32) as an independent risk factor for major recanalization and stent-assisted coiling (OR 0.34; 95%CI 0.14–0.85), use of an intermediate catheter (OR 0.38; 95%CI 0.17–0.86), and complete occlusion at second coiling (OR 0.16; 95%CI 0.034–0.72) as independent protective factors for major recanalization.Conclusions:Second coiling of recanalized aneurysms may decrease the risk of major recanalization by using a stent in combination with an intermediate catheter to achieve complete occlusion.

Stroke, Volume 56, Issue Suppl_1, Page AWMP88-AWMP88, February 1, 2025. Background:Intracranial stenting is increasingly performed after thrombectomy failure. Stent selection and procedural strategies are heterogenous between centers. Our aim is to evaluate the clinical and radiological impact of stent design among these patients.Methods:The RESISTANT registry is a multicenter, international, retrospective study of patients with acute ischemic stroke who underwent intracranial stenting from 2016 to 2023. This analysis compares outcomes based on stent type and evaluates the role of pre- and post-stenting angioplasty. The primary endpoint was 90-day good clinical outcome defined as modified Rankin Scale 0 to 2. Secondary outcomes included final reperfusion, and early stent patency (within 48 hours). Safety outcomes included procedural complications, symptomatic intracranial hemorrhage, and in-hospital mortality.Results:Among 859 patients in the RESISTANT registry, 176 underwent intracranial stenting with balloon-mounted stent (BMS) and 683 with self-expandable stent (SES). The Vertebrobasilar location was more frequent in patients who received BMS (46.6% vs 24.0%, p

Stroke, Volume 56, Issue Suppl_1, Page AWMP86-AWMP86, February 1, 2025. Background:Acute intracranial stenting for the treatment of patients with large vessel occlusion in case of failed reperfusion or severe stenosis is a growing practice. Our aim was to explore the clinical and radiological outcome in a large multicenter and international registry.Methods:The RESISTANT registry is a multicenter and international retrospective registry of patients with large vessel occlusion stroke that underwent intracranial stenting due an acute stroke from 2016 to 2023. Primary endpoints was clinical outcome at 90 days. Secondary efficacy endpoints were final reperfusion (mTICI 2b-3), and stent patency at 24 hours. Safety outcomes included procedural complications, symptomatic intracranial hemorrhage and in-hospital mortality.Results:Among 890 patients enrolled, 862 fulfilled inclusion criteria. Median age was 67.0 years (IQR 59.0-77.0), 558 (64.7%) were males and median NIHSS was 12 (IQR 7.0-19.0). Occlusion location was proximal in 758 (87.9%) patients and anterior circulation was affected in 613 (71.1%) patients (390 M1-MCA, 142 terminal ICA). The indication for intracranial stenting was failed reperfusion (mTICI 0-2a) in 456 patients (52.9%). After intracranial stenting, successful recanalization was achieved in 764 (88.6%) with a reocclusion rate during admission of 11.9% and missing controls of 17.7%. The rate of symptomatic intracranial hemorrhage was 8.1%. At 90 days, the median mRS was 3 (IQR 1-6). Successful recanalization and regular flow after stenting were predictors of functional outcome at 90 days. No variables were independently associated with early reocclusion or symptomatic intracranial hemorrhage.Conclusion:Acute intracranial stenting was an effective therapy for patients with failed reperfusion or severe stenosis. Successful reperfusion and regular flow after stenting predicted functional outcome. Prospective studies are warranted to confirm efficacy and safety.