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Stent Angioplasty in Acute-Phase ICAD-LVO: A Retrospective Cohort Study on Long-Term Recurrence and Safety Outcomes

Lin Chen1, Shuai Mi1, Yuxuan He1

  • 1Department of Neurology, The First Affiliated Hospital (Southwest Hospital), Army Medical University, Chongqing, China.

World Neurosurgery
|January 19, 2026
PubMed

Insights

Emergency stent angioplasty for intracranial atherosclerotic disease-related large vessel occlusion (ICAD-LVO) significantly reduces long-term stroke recurrence. This treatment was not linked to increased procedural complications, offering a safer approach for ICAD-LVO patients.

Area of Science:

  • Neurology
  • Vascular Surgery
  • Interventional Neuroradiology

Background:

  • Intracranial atherosclerotic disease-related large vessel occlusion (ICAD-LVO) poses a significant stroke risk.
  • Current treatment strategies lack long-term outcome data, focusing primarily on 90-day recovery.
  • The persistent risk of recurrent stroke necessitates evaluating advanced therapeutic interventions.

Purpose of the Study:

  • To investigate the efficacy of stent angioplasty in reducing long-term stroke recurrence in ICAD-LVO patients.
  • To assess whether stent angioplasty achieves successful vascular recanalization.
  • To compare the long-term outcomes of stenting versus non-stenting therapies for ICAD-LVO.

Main Methods:

  • A retrospective cohort study included 131 patients with ICAD-LVO.
  • Patients were divided into emergency stenting (65) and non-stenting therapy (66) groups.
  • Stroke recurrence from 30 days to 1 year was the primary outcome, analyzed using competing risks regression.

Main Results:

  • The 1-year cumulative incidence of stroke recurrence was lower in the stent group (4.9%) compared to the non-stent group (13.7%).
  • Stenting was significantly associated with a reduced risk of recurrence (sHR 0.19, P=0.026) after adjustment.
  • No increased risk of symptomatic intracranial hemorrhage, parenchymal hematoma type 2, or 90-day mortality was observed with stenting.

Conclusions:

  • Emergency stent angioplasty is associated with a lower risk of 30-day to 1-year stroke recurrence in ICAD-LVO.
  • Stent angioplasty did not increase the risk of procedural complications in this cohort.
  • These findings suggest stenting as a potentially effective strategy for managing ICAD-LVO and preventing recurrent strokes.
Abstract

Keywords:
Competing risk analysisIntracranial atherosclerotic disease-related large vessel occlusion (ICAD-LVO)StentingStroke recurrence

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