Clinical Study of Symptomatic Nonacute Intracranial Large Arterial Occlusion with Endovascular Recanalization.

J Neurol Surg B Skull Base

Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, People's Republic of China.

Published: October 2024

 This study reported a single-center clinical trial of endovascular treatment for symptomatic nonacute occlusion of the intracranial large artery (NA-ILAO). The aim of this study was to evaluate the safety, feasibility, and clinical effect of simple balloon dilatation and stent implantation.  The patients diagnosed with symptomatic NA-ILAO were enrolled. A total of 40 cases were included in this study. While recanalization failed in 4 patients, it was successful in 36 patients, who were then divided into two groups for further analysis: balloon dilatation group (  = 24) and stent implantation group (  = 12). The perioperative complications, clinical outcome, and follow-up results were analyzed.  Perioperative complications in the stent implantation group were significantly higher than those in the simple balloon dilatation group (  < 0.05). There were 21 and 10 cases of 90-day good clinical outcome (modified Rankin scale [mRS] ≤ 2) in the balloon and stent groups, respectively (  = 0.518). All patients with successful recanalization underwent digital subtraction angiography (DSA) or CT angiography (CTA) during an average follow-up of 14 months. There were two cases of restenosis in the balloon dilatation group and one in the stent implantation group (  = 1.000). There were two cases of re-occlusion in the stent group and none in the balloon dilatation group (  < 0.001). Stroke recurred in two cases in the stent group and in one case in the simple balloon dilatation group (  = 0.013).  Endovascular recanalization is safe and feasible for patients with symptomatic NA-ILAO. Compared with stent implantation, simple balloon dilation may be a better recanalization method, but larger randomized controlled trials are needed to confirm it.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368458PMC
http://dx.doi.org/10.1055/s-0043-1774791DOI Listing

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