Observation of the Angioplasty Effect of Stent-Retriever Thrombectomy in Acute Intracranial Atherosclerotic Artery Stenosis

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Acute intracranial atherosclerotic stenosis (ICAS) with large-vessel occlusion (n=4). Intervention: Stent-retriever thrombectomy combined with aspiration and 10-30 minute angiographic blood flow observation. Primary outcome: Sustained vascular patency without rescue stent implantation during 10-30 minutes of post-thrombectomy observation.

Xueli Cai; Kaiqi Zhu; Yuzhen Wang; Hao Chen; Chen Xiao; Jingping Sun

doi:10.1097/nrl.0000000000000650

February 4, 2026The NeurologistOpen Access

Observation of the Angioplasty Effect of Stent-Retriever Thrombectomy in Acute Intracranial Atherosclerotic Artery Stenosis

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Key result

Stent-retriever thrombectomy leads to acute reocclusion in ~75% of ICAS cases, requiring rescue stenting.

n=4

Key Points

To describe the transient angioplasty effect after stent-retriever thrombectomy and evaluate its role in arterial reocclusion among patients with acute intracranial atherosclerotic stenosis.
Retrospective case series of 4 male patients (aged 57–73 years) with acute large-vessel occlusion secondary to intracranial atherosclerotic stenosis who underwent endovascular treatment.
Blood flow was observed via digital subtraction angiography for 10 to 30 minutes following stent-retriever thrombectomy to detect arterial reocclusion and evaluate the need for permanent stent placement.
Initial stent-retriever thrombectomy achieved transient vessel expansion, but blood flow weakened and became unsustainable during 10 to 30 minutes of observation in 3 of 4 patients, requiring rescue stent implantation to achieve mTICI grade III blood flow.
In Case 4, immediate mTICI grade III recanalization was achieved without stenting, but follow-up CT angiography 4 days later revealed recurrent stenosis and occlusion of the left middle cerebral artery M1 segment.
Across all 4 patients, admission NIHSS scores ranged from 9 to 25, 90-day modified Rankin Scale scores ranged from 0 to 5, and no symptomatic intracerebral hemorrhage or death occurred.

Study Design

Type

Case Report (n=4)

Multicenter

No

PICO

P

Population

4 male patients (aged 57-73 years) with acute intracranial atherosclerotic stenosis and large-vessel occlusion treated with endovascular thrombectomy and followed for 90 days.

I

Intervention / Comparator

Stent-retriever thrombectomy combined with aspiration and 10-30 minute angiographic blood flow observation

O

Primary Outcome

Sustained vascular patency without rescue stent implantation during 10-30 minutes of post-thrombectomy observation

Limitations

Retrospective case series with a very small sample size of 4 patients
Single-center study without a control group
Limited evidence regarding the optimal duration of postprocedural angiographic monitoring
Prolonged intraoperative observation increases surgery and anesthesia duration and associated cardiopulmonary and infection risks

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Implication

Retrospective case series observes angioplasty effect in ICAS, suggesting implications for endovascular treatment strategies.

Abstract

Intracranial atherosclerotic stenosis (ICAS) is one of the most common causes of ischemic stroke worldwide, and endovascular treatment is the primary therapeutic approach, but the clinical recanalization rate is low. Clinical practice has revealed the occurrence of an angioplasty effect following endovascular treatment, which may explain the low recanalization rate. Four patients with ICAS who underwent endovascular therapy were included in this retrospective case series. Demographic, medical histories, treatment, and outcome data were extracted. After undergoing stent-retriever thrombectomy, patients were monitored to assess whether the stenosis showed transient improvement only. The blood flow was observed for 10 to 30 minutes by digital subtraction angiography (DSA), and stent implantation was considered. Clinical data were collected on 4 patients with ICAS who received endovascular treatment. Therefore, we propose the angioplasty effect of stent-retriever thrombectomy, which holds significant value in guiding endovascular treatment.

Discussion

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Cite This Study

Cai et al. (2026) conducted a case report in Acute intracranial atherosclerotic stenosis (ICAS) with large-vessel occlusion (n=4). Stent-retriever thrombectomy combined with aspiration and 10-30 minute angiographic blood flow observation was evaluated on Sustained vascular patency without rescue stent implantation during 10-30 minutes of post-thrombectomy observation. Stent-retriever thrombectomy transiently improved stenosis in all 4 ICAS patients (100%), but 3 of 4 (75%) experienced reocclusion within 10-30 minutes requiring rescue stent implantation.

synapsesocial.com/papers/698586238f7c464f2300a192 https://doi.org/10.1097/nrl.0000000000000650

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Observation of the Angioplasty Effect of Stent-Retriever Thrombectomy in Acute Intracranial Atherosclerotic Artery Stenosis

Key Points

Study Design

PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Observation of the Angioplasty Effect of Stent-Retriever Thrombectomy in Acute Intracranial Atherosclerotic Artery Stenosis

Key Points

Study Design

PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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