Comparison of safety and efficacy of different endovascular treatments for symptomatic intracranial atherosclerotic stenosis: results from a single center

BackgroundSymptomatic intracranial atherosclerotic stenosis (sICAS) is one of the common causes of ischemic stroke. However, the treatment of sICAS has remained a challenge in the past with unfavorable findings. This study aimed to evaluate the effectiveness and safety of different endovascular trea...

Full description

Saved in:
Bibliographic Details
Main Authors: Qiao Lin, Kaiyi Zhong, Xiyue Pan, Congfang Li, Xiaozhen Lu, Naidong Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1539127/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850232736688635904
author Qiao Lin
Kaiyi Zhong
Xiyue Pan
Congfang Li
Xiaozhen Lu
Naidong Wang
author_facet Qiao Lin
Kaiyi Zhong
Xiyue Pan
Congfang Li
Xiaozhen Lu
Naidong Wang
author_sort Qiao Lin
collection DOAJ
description BackgroundSymptomatic intracranial atherosclerotic stenosis (sICAS) is one of the common causes of ischemic stroke. However, the treatment of sICAS has remained a challenge in the past with unfavorable findings. This study aimed to evaluate the effectiveness and safety of different endovascular treatment methods for sICAS.MethodsThe study involved 154 patients with sICAS who received endovascular treatment at Qingdao University Hospital between January 2021 and October 2023. Based on the characteristics of the lesions, three different types of treatments were performed: bare metal stent group (BMS group), drug-coated balloon group (DCB group), and drug-eluting stent group (DES group). The primary endpoints included the incidence of in-stent restenosis (ISR) in the 6-month, periprocedural complications, the rate of stroke recurrence in the area of the stented artery during the follow-up period, and modified Rankin score (mRS) at discharge, at 1-month, at 3-month, at 6-month of patients after stenting.ResultsThe incidence of perioperative complications did not differ significantly between groups (11.3% in the BMS group, 8.0% in the DCB group, and 6.1% in the DES group, p = 0.776). All patients (154/154) had successful reperfusion after endovascular treatment. The incidence of stroke during follow-up was 4.5% (7/154), with 5 (7.0%) patients in the BMS group, 1 (2.0%) patient in the DCB group, and 1 (3.0%) patient in the DES group. The restenosis rate in the BMS group [35.2% (25/71)] tended to be higher than that in the DCB group [6.0% (3/50)] and DES group [9.1% (3/33)]. In multivariate logistic regression analysis, endovascular treatment strategy and vessel distribution were significant independent risk factors for ISR within 6 months (p < 0.05).ConclusionAdverse events and success rates following stent implantation are comparable across therapy groups in individuals with sICAS. When compared to BMS, DES, and DCB reduce the risk of ISR, with the advantages of the DCB appearing to be greater for some high-risk patients with ICAS.
format Article
id doaj-art-ea8d067dcdab4b508cc3e12b7bd76ab2
institution OA Journals
issn 1664-2295
language English
publishDate 2025-03-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Neurology
spelling doaj-art-ea8d067dcdab4b508cc3e12b7bd76ab22025-08-20T02:03:06ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-03-011610.3389/fneur.2025.15391271539127Comparison of safety and efficacy of different endovascular treatments for symptomatic intracranial atherosclerotic stenosis: results from a single centerQiao Lin0Kaiyi Zhong1Xiyue Pan2Congfang Li3Xiaozhen Lu4Naidong Wang5Department of General Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaDepartment of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaDepartment of General Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaDepartment of General Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaDepartment of General Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaDepartment of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaBackgroundSymptomatic intracranial atherosclerotic stenosis (sICAS) is one of the common causes of ischemic stroke. However, the treatment of sICAS has remained a challenge in the past with unfavorable findings. This study aimed to evaluate the effectiveness and safety of different endovascular treatment methods for sICAS.MethodsThe study involved 154 patients with sICAS who received endovascular treatment at Qingdao University Hospital between January 2021 and October 2023. Based on the characteristics of the lesions, three different types of treatments were performed: bare metal stent group (BMS group), drug-coated balloon group (DCB group), and drug-eluting stent group (DES group). The primary endpoints included the incidence of in-stent restenosis (ISR) in the 6-month, periprocedural complications, the rate of stroke recurrence in the area of the stented artery during the follow-up period, and modified Rankin score (mRS) at discharge, at 1-month, at 3-month, at 6-month of patients after stenting.ResultsThe incidence of perioperative complications did not differ significantly between groups (11.3% in the BMS group, 8.0% in the DCB group, and 6.1% in the DES group, p = 0.776). All patients (154/154) had successful reperfusion after endovascular treatment. The incidence of stroke during follow-up was 4.5% (7/154), with 5 (7.0%) patients in the BMS group, 1 (2.0%) patient in the DCB group, and 1 (3.0%) patient in the DES group. The restenosis rate in the BMS group [35.2% (25/71)] tended to be higher than that in the DCB group [6.0% (3/50)] and DES group [9.1% (3/33)]. In multivariate logistic regression analysis, endovascular treatment strategy and vessel distribution were significant independent risk factors for ISR within 6 months (p < 0.05).ConclusionAdverse events and success rates following stent implantation are comparable across therapy groups in individuals with sICAS. When compared to BMS, DES, and DCB reduce the risk of ISR, with the advantages of the DCB appearing to be greater for some high-risk patients with ICAS.https://www.frontiersin.org/articles/10.3389/fneur.2025.1539127/fulldrug-eluding stentdrug-coated balloonendovascular treatmentin-stent restenosisbare metal stent
spellingShingle Qiao Lin
Kaiyi Zhong
Xiyue Pan
Congfang Li
Xiaozhen Lu
Naidong Wang
Comparison of safety and efficacy of different endovascular treatments for symptomatic intracranial atherosclerotic stenosis: results from a single center
Frontiers in Neurology
drug-eluding stent
drug-coated balloon
endovascular treatment
in-stent restenosis
bare metal stent
title Comparison of safety and efficacy of different endovascular treatments for symptomatic intracranial atherosclerotic stenosis: results from a single center
title_full Comparison of safety and efficacy of different endovascular treatments for symptomatic intracranial atherosclerotic stenosis: results from a single center
title_fullStr Comparison of safety and efficacy of different endovascular treatments for symptomatic intracranial atherosclerotic stenosis: results from a single center
title_full_unstemmed Comparison of safety and efficacy of different endovascular treatments for symptomatic intracranial atherosclerotic stenosis: results from a single center
title_short Comparison of safety and efficacy of different endovascular treatments for symptomatic intracranial atherosclerotic stenosis: results from a single center
title_sort comparison of safety and efficacy of different endovascular treatments for symptomatic intracranial atherosclerotic stenosis results from a single center
topic drug-eluding stent
drug-coated balloon
endovascular treatment
in-stent restenosis
bare metal stent
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1539127/full
work_keys_str_mv AT qiaolin comparisonofsafetyandefficacyofdifferentendovasculartreatmentsforsymptomaticintracranialatheroscleroticstenosisresultsfromasinglecenter
AT kaiyizhong comparisonofsafetyandefficacyofdifferentendovasculartreatmentsforsymptomaticintracranialatheroscleroticstenosisresultsfromasinglecenter
AT xiyuepan comparisonofsafetyandefficacyofdifferentendovasculartreatmentsforsymptomaticintracranialatheroscleroticstenosisresultsfromasinglecenter
AT congfangli comparisonofsafetyandefficacyofdifferentendovasculartreatmentsforsymptomaticintracranialatheroscleroticstenosisresultsfromasinglecenter
AT xiaozhenlu comparisonofsafetyandefficacyofdifferentendovasculartreatmentsforsymptomaticintracranialatheroscleroticstenosisresultsfromasinglecenter
AT naidongwang comparisonofsafetyandefficacyofdifferentendovasculartreatmentsforsymptomaticintracranialatheroscleroticstenosisresultsfromasinglecenter