{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T05:18:26Z","timestamp":1787894306041,"version":"build-2784847793"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Conventional mechanical thrombectomy (MT) for acute ischemic stroke (AIS) due to intracranial atherosclerosis-related large vessel occlusion (ICAS-LVO) is associated with low first-pass reperfusion (FPR), distal embolization, and recurrent thrombosis. We designed a novel stepwise endovascular strategy, the RESCUE (Retrievable stent-Endovascular tirofiban-paSs-ExtraCtion-microgUide-rEscue angioplasty) technique, and compared its safety and efficacy with that of the standard Solumbra technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective, randomized, single-center trial, 85 patients presenting with AIS due to ICAS-LVO were enrolled consecutively. Eligible participants underwent randomization to either the RESCUE group (43 patients) or Solumbra group (42 patients). The primary endpoint was FPR, defined as achieving modified Thrombolysis in Cerebral Infarction (mTICI) grade 2c-3. Secondary endpoints comprised: favorable 90-day functional status [modified Rankin Scale (mRS) score \u22642 for anterior strokes or \u22643 for posterior strokes]; procedural duration from groin puncture to first recanalization; number of retrieval attempts; distal embolization; early reocclusion; symptomatic intracranial hemorrhage (sICH); and death within 90\u202fdays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A significant difference in FPR rates was observed between the two groups, favoring the RESCUE group [86.0% (37\/43) vs. 61.9% (26\/42);\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.011]. The RESCUE group had a shorter median procedural duration [40.0\u202fmin (interquartile range (IQR) 30.0\u201350.0\u202fmin) vs. 60.0\u202fmin (IQR 43.0\u201377.0\u202fmin);\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.010]. Successful reperfusion, defined as mTICI grade \u22652b, occurred in 93.0% of patients in the RESCUE group and 90.5% of those in the Solumbra group (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.373). At the 90-day follow-up, a favorable functional outcome was noted in 60.5% (26\/43) of RESCUE group patients and 57.1% (24\/42) of Solumbra group patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.483). No significant between-group differences emerged in the incidence of sICH (2.3% vs. 4.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f1.000) or 90-day mortality (0% vs. 4.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.237).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The RESCUE technique is a safe and effective lesion-specific endovascular strategy for ICAS-LVO, providing superior FPR and shorter procedural time compared with the conventional Solumbra technique, without increasing safety concerns. Larger-scale multicenter investigations are needed to confirm these results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1886448","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T04:31:06Z","timestamp":1787891466000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["An innovative endovascular approach for acute ischemic stroke attributable to ICAS-LVO: the RESCUE (Retrievable stent-Endovascular tirofiban-paSs-ExtraCtion-microgUide-rEscue angioplasty) technique"],"prefix":"10.3389","volume":"17","author":[{"given":"Yingchun","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Neurology, ORDOS Central Hospital","place":["Ordos, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanzhang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, ORDOS Central Hospital","place":["Ordos, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuejiang","family":"Gui","sequence":"additional","affiliation":[{"name":"Department of Neurology, ORDOS Central Hospital","place":["Ordos, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Neurology, ORDOS Central Hospital","place":["Ordos, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanqing","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Neurology, ORDOS Central Hospital","place":["Ordos, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenzhao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, ORDOS Central Hospital","place":["Ordos, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Neurology, ORDOS Central Hospital","place":["Ordos, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, ORDOS Central Hospital","place":["Ordos, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhipeng","family":"Hua","sequence":"additional","affiliation":[{"name":"Department of Neurology, ORDOS Central Hospital","place":["Ordos, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1136\/jnnp-2020-325630","article-title":"Intracranial arterial stenosis in Caucasian versus Chinese patients with TIA and minor stroke: two contemporaneous cohorts and a systematic review","volume":"92","author":"Leng","year":"2021","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1460","DOI":"10.1161\/strokeaha.119.024889","article-title":"Thrombectomy outcomes of intracranial atherosclerosis-related occlusions","volume":"50","author":"Tsang","year":"2019","journal-title":"Stroke"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1695","DOI":"10.1161\/strokeaha.122.040008","article-title":"Large vessel occlusion stroke due to intracranial atherosclerotic disease: identification, medical and interventional treatment, and outcomes","volume":"54","author":"de Havenon","year":"2023","journal-title":"Stroke"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"734971","DOI":"10.3389\/fneur.2021.734971","article-title":"Rescue endovascular treatment for emergent large vessel occlusion with underlying intracranial atherosclerosis: current state and future directions","volume":"12","author":"Al Kasab","year":"2021","journal-title":"Front Neurol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"394","DOI":"10.5853\/jos.2018.01627","article-title":"Prognosis of acute intracranial atherosclerosis-related occlusion after endovascular treatment","volume":"20","author":"Lee","year":"2018","journal-title":"J Stroke"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1159\/000362435","article-title":"Instant reocclusion following mechanical thrombectomy of in situ thromboocclusion and the role of low-dose intra-arterial tirofiban","volume":"37","author":"Kang","year":"2014","journal-title":"Cerebrovasc Dis"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e020195","DOI":"10.1161\/jaha.120.020195","article-title":"Outcomes of rescue endovascular treatment of emergent large vessel occlusion in patients with underlying intracranial atherosclerosis: insights from STAR","volume":"10","author":"Al Kasab","year":"2021","journal-title":"J Am Heart 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Neurol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2925","DOI":"10.1161\/strokeaha.120.029994","article-title":"Intraarterial versus intravenous Tirofiban as an adjunct to endovascular Thrombectomy for acute ischemic stroke","volume":"51","author":"Yang","year":"2020","journal-title":"Stroke"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1089","DOI":"10.3390\/brainsci12081089","article-title":"Long-term outcomes of local tirofiban infusion for intracranial atherosclerosis-related occlusion","volume":"12","author":"Choi","year":"2022","journal-title":"Brain Sci"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1701","DOI":"10.3174\/ajnr.A8374","article-title":"Stent retriever assisted lysis technique with tirofiban: a potential bailout alternative to angioplasty and stenting","volume":"45","author":"Rodrigo-Gisbert","year":"2024","journal-title":"AJNR Am J 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Second European-Australasian acute stroke study investigators","volume":"352","author":"Hacke","year":"1998","journal-title":"Lancet"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1428","DOI":"10.1056\/NEJMe2210737","article-title":"Favorable outcomes in endovascular therapy for basilar-artery occlusion","volume":"387","author":"Schonewille","year":"2022","journal-title":"N Engl J Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1136\/neurintsurg-2015-012122","article-title":"Comparison of clinical outcomes in patients with acute ischemic strokes treated with mechanical thrombectomy using either Solumbra or ADAPT techniques","volume":"8","author":"Delgado Almandoz","year":"2016","journal-title":"J Neurointerv Surg"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1056\/NEJMoa2503678","article-title":"Early tirofiban infusion after intravenous thrombolysis for stroke","volume":"393","author":"Tao","year":"2025","journal-title":"N Engl J Med"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"e036350","DOI":"10.1161\/jaha.124.036350","article-title":"Effect of intravenous Tirofiban versus placebo on first-pass successful reperfusion in endovascular stroke Thrombectomy: insights from the RESCUE BT randomized clinical trial","volume":"13","author":"Yuan","year":"2024","journal-title":"J Am Heart Assoc"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1177\/1591019916632369","article-title":"ARTS (aspiration-retriever technique for stroke): initial clinical experience","volume":"22","author":"Massari","year":"2016","journal-title":"Interv Neuroradiol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1007\/s00062-017-0566-z","article-title":"Maximizing first-pass complete reperfusion with SAVE","volume":"28","author":"Maus","year":"2018","journal-title":"Clin Neuroradiol"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1886448\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T04:31:18Z","timestamp":1787891478000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1886448\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,28]]},"references-count":24,"alternative-id":["10.3389\/fneur.2026.1886448"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1886448","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,28]]},"article-number":"1886448"}}