The resolute Onyx in TIA management (ROTIA)

Area of Science:

• Neurology
• Interventional Cardiology
• Vascular Surgery

Background:

• Medical management is the first-line treatment for symptomatic intracranial atherosclerotic disease (ICAD).
• Interventional approaches are increasingly considered for refractory ICAD cases.
• The Resolute Onyx (R-Onyx) drug-eluting stent was evaluated for off-label use in treating recurrent TIAs due to refractory ICAD.

Purpose of the Study:

• To evaluate the safety and efficacy of the Resolute Onyx drug-eluting stent in patients with recurrent TIAs from refractory ICAD.
• To assess peri-procedural complications and long-term ischemic events after stenting.

Main Methods:

• A single-center, retrospective case series of 20 patients treated with R-Onyx angioplasty and stenting.
• Patients had recurrent TIAs from >70% intracranial artery stenosis despite maximal medical therapy.
• Outcomes included peri-procedural complications and ischemic stroke up to 18 months post-stenting.

Main Results:

• Twenty patients underwent successful deployment of 21 R-Onyx stents with no peri-procedural complications.
• No recurrent ischemic events were observed at 30 days post-stenting.
• At 18 months, no ischemic events or in-stent restenosis occurred.

Conclusions:

• The Resolute Onyx drug-eluting stent is feasible for managing TIAs in refractory ICAD, demonstrating high technical success and low complication rates.
• Limitations include the retrospective, single-center design.
• Prospective, multi-center, randomized trials with longer follow-up are warranted.