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This study aimed to evaluate whether the severity of stenosis affects the outcomes after RS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this multicenter retrospective study, patients with acute middle cerebral artery occlusion and underlying ICAS were divided into two groups based on the treatment they received: mechanical thrombectomy (MT)\u202f+\u2009RS (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u2009172) or MT-only (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u2009131). Inverse probability of treatment weighting was used to balance baseline characteristics. We systematically evaluated stenosis thresholds from 40% to 90% to identify the optimal cutoff that best differentiated treatment effects on the 90-day modified Rankin Scale (mRS) score and safety outcomes, including symptomatic intracranial hemorrhage (sICH).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A\u00a0stenosis severity of 75% was identified as the optimal cutoff for effect modification. While RS improved recanalization rates overall, its effect on the 90-day mRS score was beneficial only in patients with &gt;\u202f75% stenosis compared to MT-only (Average Treatment Effect (ATE) \u22120.98, 95% CI \u22121.73 to \u22120.22;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090.01). In contrast, it showed a\u00a0detrimental effect in those with &lt;\u202f75% stenosis (ATE 1.08, 95% CI 0.32 to 1.83;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090.005). Furthermore, RS increased the rate of sICH regardless of ICAS severity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The clinical benefit of RS is contingent on the underlying stenosis severity, providing favorable outcomes in patients with high-grade stenoses only. ICAS severity should also be considered for treatment decisions, though these findings require validation in prospective controlled studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00062-026-01635-7","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T22:29:35Z","timestamp":1772231375000},"page":"711-720","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Stenosis Severity on Outcomes After Rescue Stenting for Acute Middle Cerebral Artery Occlusions: a\u00a0Real-world Multicenter Analysis"],"prefix":"10.1007","volume":"36","author":[{"given":"Andrea 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