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Early versus Delayed Drug-Coated Balloons for Symptomatic Intracranial Atherosclerotic Stenosis.

Xiaofei Sun1, Yayue Liu1, Lucynda Pham2

  • 1Department of Neurology, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao 266000, China.

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Summary
This summary is machine-generated.

Performing drug-coated balloon (DCB) angioplasty for symptomatic intracranial atherosclerotic stenosis (sICAS) between 21-42 days after an event, rather than within 21 days, significantly reduces restenosis. This delayed intervention timing appears safer for sICAS patients undergoing DCB therapy.

Keywords:
DCBICASStrokeTIA

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Area of Science:

  • Neurology
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Drug-coated balloons (DCB) are effective for intracranial atherosclerotic stenosis (ICAS).
  • Optimal timing for DCB intervention in ICAS remains debated.
  • Limited research exists on early versus delayed DCB treatment for ICAS.

Purpose of the Study:

  • To compare clinical outcomes of early (≤21 days) versus delayed (21-42 days) DCB treatment in symptomatic ICAS (sICAS) patients.
  • To evaluate the efficacy and safety of DCB angioplasty based on intervention timing.
  • To assess rates of residual stenosis, restenosis, perioperative complications, and recurrence.

Main Methods:

  • Retrospective study of 186 sICAS patients undergoing DCB angioplasty (August 2021 - March 2024).
  • Patients divided into early (≤21 days) and delayed (21-42 days) groups based on time from qualifying event to procedure.
  • Comparison of postoperative residual stenosis, 12-month restenosis, perioperative complications, and recurrence rates between groups.

Main Results:

  • The delayed group (21-42 days) had significantly lower postoperative residual stenosis (10% vs. 20%, P=0.041) and 12-month restenosis rates (10.81% vs. 22.67%, P=0.029) compared to the early group (≤21 days).
  • The delayed group showed numerically lower, though not statistically significant, rates of perioperative complications (5.41% vs. 9.33%) and recurrence (7.21% vs. 9.33%).
  • All 186 patients successfully underwent DCB angioplasty.

Conclusions:

  • Performing DCB angioplasty for sICAS within 21 days is associated with higher residual stenosis and increased long-term restenosis risk.
  • Delayed DCB intervention (21-42 days) demonstrates improved outcomes in terms of residual stenosis and restenosis.
  • The findings suggest that a delayed intervention window may be more beneficial for sICAS patients treated with DCB angioplasty.