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Intracranial atherosclerotic disease (ICAD) is a major cause of stroke and presents a unique challenge with a high rate of reocclusion following mechanical thrombectomy, leading to less favorable clinical outcomes. When standard thrombectomy is unsuccessful, rescue treatments for persistent ICAD-related occlusion or stenosis are needed. Among the available options, glycoprotein inhibitors have shown promise as a potential therapeutic strategy in the setting of ICAD. This systematic review examines studies that explore the use of glycoprotein inhibitors as an acute standalone post-EVT rescue treatment for refractory occlusion or high-grade stenosis in the setting of ICAD stroke.

Databases searched, including Embase, Pubmed, and Medline from the date of conception through March 1st, 2023. We included studies using GPI as the first-line rescue treatment after failed thrombectomy or in the …