Effect of Drug-Coated Balloon Versus Stent Angioplasty in Patients With Symptomatic Intracranial Atherosclerotic...

Area of Science:

• Neurology
• Interventional Cardiology
• Vascular Surgery

Background:

• Drug-coated balloons (DCBs) demonstrate efficacy in peripheral and coronary arteries.
• Evidence for DCBs in intracranial vasculature for symptomatic intracranial atherosclerotic stenosis (sICAS) remains limited.
• This study investigates DCB safety and efficacy compared to stenting in sICAS.

Purpose of the Study:

• To assess the safety and efficacy of DCBs versus stent angioplasty for sICAS.
• To identify patient subgroups who may benefit most from DCB treatment.
• To compare perioperative adverse events and 12-month restenosis rates.

Main Methods:

• Retrospective cohort study of 154 patients with sICAS (June 2021-May 2022).
• 1:2 propensity score matching created comparable groups: DCB (n=43) and stent (n=75).
• Primary endpoints: perioperative stroke/mortality and 12-month target vessel restenosis.

Main Results:

• Lower incidence of perioperative adverse events in the DCB group (2.3% vs. 8.0%).
• Significantly lower 12-month restenosis rates in the DCB group (11.9% vs. 28.0%, P=.045).
• DCB angioplasty significantly reduced luminal stenosis, especially in the middle cerebral artery M1 segment.

Conclusions:

• DCB angioplasty presents a safe and effective alternative to stenting for sICAS.
• DCBs may be particularly beneficial for patients with middle cerebral artery M1 segment stenosis.
• Further research is warranted to confirm these findings in larger, prospective studies.