World neurosurgery · 2026
Application of an Intracranial Drug-Eluting Stent in Intracranial Atherosclerotic Stenosis-Related Emergent Large Vessel Occlusion.
СтатьяНазвание и аннотация: Перевод в очереди
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Qing Yi, Lai Hetai, Cheng Guangsen, Wu Yaoxiang, Li Zhongliang
Аннотация
OBJECTIVE: This study aims to evaluate the clinical effectiveness of intracranial artery drug-eluting stent (DES) in patients with intracranial atherosclerotic stenosis (ICAS)‑related emergent large vessel occlusion (ELVO), explore their safety and short-term prognosis, and provide a basis for optimizing the endovascular treatment strategy for ICAS-ELVO.
METHODS: The clinical data of 32 patients with ICAS-ELVO who underwent emergency endovascular treatment with DES implantation were retrospectively analyzed. We observed the postprocedural revascularization rate (modified Thrombolysis in Cerebral Infarction ≥ grade 2b), the degree of target vessel stenosis, and periprocedural complications. Additionally, we performed clinical and imaging follow-up at 30 days and approximately 6 months postoperatively to assess prognosis and in-stent restenosis (ISR) rate.
RESULTS: The DES was successfully implanted in all 32 patients (100% technical success rate), with a significant reduction in culprit vessel stenosis from a median of 85% to 5% postprocedure (P < 0.001). The 30-day perioperative adverse event rate was 9.3%, with acute in-stent thrombosis, symptomatic intracranial hemorrhage, and death each occurring in 1 patient (3.1% per event). Angiographic follow-up was completed in 28 of 31 surviving patients (90%), showing an ISR rate of 3.6% (95% confidence interval: 0.1%-19%). Sensitivity analysis for 3 lost patients yielded an adjusted range of 3.2%-13%. No new ischemic events or deaths occurred after the 30-day perioperative period.
CONCLUSIONS: In this selected cohort of patients with ICAS-ELVO, emergency DES placement demonstrated high technical feasibility and a low ISR rate among those with angiographic follow-up. These preliminary findings warrant prospective validation.
METHODS: The clinical data of 32 patients with ICAS-ELVO who underwent emergency endovascular treatment with DES implantation were retrospectively analyzed. We observed the postprocedural revascularization rate (modified Thrombolysis in Cerebral Infarction ≥ grade 2b), the degree of target vessel stenosis, and periprocedural complications. Additionally, we performed clinical and imaging follow-up at 30 days and approximately 6 months postoperatively to assess prognosis and in-stent restenosis (ISR) rate.
RESULTS: The DES was successfully implanted in all 32 patients (100% technical success rate), with a significant reduction in culprit vessel stenosis from a median of 85% to 5% postprocedure (P < 0.001). The 30-day perioperative adverse event rate was 9.3%, with acute in-stent thrombosis, symptomatic intracranial hemorrhage, and death each occurring in 1 patient (3.1% per event). Angiographic follow-up was completed in 28 of 31 surviving patients (90%), showing an ISR rate of 3.6% (95% confidence interval: 0.1%-19%). Sensitivity analysis for 3 lost patients yielded an adjusted range of 3.2%-13%. No new ischemic events or deaths occurred after the 30-day perioperative period.
CONCLUSIONS: In this selected cohort of patients with ICAS-ELVO, emergency DES placement demonstrated high technical feasibility and a low ISR rate among those with angiographic follow-up. These preliminary findings warrant prospective validation.