{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:30:23Z","timestamp":1790173823535,"version":"4.1.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005743","name":"Universit\u00e0 Cattolica del Sacro Cuore","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005743","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Neuroradiol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Mechanical thrombectomy (MT) is standard care for acute large vessel occlusion (LVO), but it fails in 10\u201320% of cases, often due to underlying intracranial artery stenosis (ICAS). In such cases, rescue stenting (RS), with or without angioplasty, may improve recanalization, but its clinical benefit remains debated. The purpose of this study was to define predictors of clinical outcome in this patient population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a\u00a0retrospective multicenter study including 115 patients with ICAS-related occlusion of the middle cerebral artery (MCA) treated with MT and RS across 27\u00a0international stroke centers. Baseline, procedural, and post-procedural variables were analyzed. The outcome measure was the ordinal shift of the 90-day modified Rankin Scale (mRS) score. Stepwise multivariate regression and structural equation modeling (SEM) were used to identify outcome predictors and explore mediation pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Successful recanalization (modified Treatment in Cerebral Infarction (mTICI) score \u2265\u202f2b) was achieved in 94.8% of patients, with 73.0% reaching mTICI\u00a02c\u20113. SEM showed that baseline Alberta Stroke Program Early CT Score (ASPECTS), stenting with angioplasty and achieving mTICI\u00a02c\u20113 were associated with improved functional outcome, mediated by higher post-procedural ASPECTS. Post-procedural ASPECTS influenced functional outcome both directly (estimate\u202f=\u2009\u22120.45,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&lt;\u20090.001) and indirectly by reducing the occurrence of symptomatic intracranial hemorrhage (sICH) (estimate\u202f=\u2009\u22120.09,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090.004). This model explained 36.5% of the variance in 90-day mRS scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with acute ICAS-related MCA occlusion, stenting with angioplasty and achieving mTICI\u00a02c\u20133 recanalization are associated with improved clinical outcome. These benefits are mediated by better post-procedural ASPECTS and reduced sICH. Prospective studies are warranted to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00062-025-01577-6","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T06:02:58Z","timestamp":1760335378000},"page":"329-337","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Stenting with Angioplasty and MTICI\u00a02c-3 Recanalization On Outcome in Acute MCA Occlusion with Underlying Stenosis"],"prefix":"10.1007","volume":"36","author":[{"given":"Andrea 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Alexandre, A. Consoli, L. Scarcia, E. Di Stasio, V. Brunetti, W. Sun, Y. Xu, X. Huang, C. Chung, A. Sgreccia, M. Abdalkader, N. Limbucci, A. Pedicelli, F. Capasso, F. Arba, L. Migliaccio, M. Piano, M. Ganimede, E. Lozupone, C. Gaudino, F. Ricchetti, R. Russo, J. Burel, F. D\u2019Argento, S. Abruzzese, J. Allard, N. Chausson, R. Partesano, N. Cavasin, N. Mandruzzato, J. Gabrieli, P. Trombatore, A. Caragliano, F. Mazzacane, G. Salsano, A. Sanna, P. Panni, A. Zini, F. Claren\u00e7on, E. Raz, T. Nguyen and A. Broccolini declare that there are no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}