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

IF 6.9 2区医学 Q1 CLINICAL NEUROLOGY

Neurotherapeutics Pub Date : 2025-09-01 DOI:10.1016/j.neurot.2025.e00689

Xiaofei Sun , Yayue Liu , Lucynda Pham , Guangwen Li

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引用次数: 0

Abstract

In recent years, drug-coated balloons (DCB) have been increasingly used for intervention therapy of intracranial atherosclerotic stenosis (ICAS) with significant efficacy. However, the timing of DCB intervention therapy remains controversial, and there are few published studies that further investigated this. This study aimed to evaluate the clinical outcomes of early (≤21 days) versus delayed (21–42 days) DCB treatment in patients with ICAS. Symptomatic ICAS (sICAS) patients who underwent DCB angioplasty between August 2021 and March 2024 were included in the study. Based on the time from the last qualifying event (QE) to the procedure, patients were divided into an early group (≤21 days) and a delayed group (21–42 days). The efficacy and safety of DCB angioplasty, including perioperative complications and restenosis, were recorded and compared between the two groups. A total of 186 patients were enrolled, with 75 in the early group and 111 in the delayed group where all patients underwent DCB angioplasty successfully. The delayed group showed significantly lower postoperative residual stenosis (10 % vs. 20 %, P = 0.041) and restenosis rates (10.81 % vs. 22.67 %, P = 0.029) at the 12-month follow-up compared to the early group. The delayed group also had numerically lower perioperative complication rates (5.41 % vs. 9.33 %, P = 0.303) and recurrence rates (7.21 % vs. 9.33 %, P = 0.601), however these differences were not statistically significant. Our study concludes that in patients with sICAS, performing DCB angioplasty within 21 days may carry a higher degree of residual stenosis and an increased long-term risk of restenosis.

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sICAS的早期与延迟DCB。

近年来，药物包被球囊（drug-coated balloons， DCB）越来越多地用于颅内动脉粥样硬化性狭窄（intracranial atherosclerosis stenosis， ICAS）的介入治疗，疗效显著。然而，DCB干预治疗的时机仍然存在争议，并且很少有已发表的研究对此进行进一步研究。本研究旨在评估ICAS患者早期（≤21天）与延迟（21-42天）DCB治疗的临床结果。在2021年8月至2024年3月期间接受DCB血管成形术的症状性ICAS （sICAS）患者被纳入研究。根据从最后一次合格事件（QE）到手术的时间，将患者分为早期组（≤21天）和延迟组（21-42天）。记录两组DCB血管成形术的疗效和安全性，包括围手术期并发症和再狭窄。共纳入186例患者，早期组75例，延迟组111例，所有患者均成功行DCB血管成形术。在12个月的随访中，延迟组的术后残余狭窄（10%比20%，P = 0.041）和再狭窄率（10.81%比22.67%,P = 0.029）明显低于早期组。延迟组围手术期并发症发生率（5.41%比9.33%,P = 0.303）和复发率（7.21%比9.33%,P = 0.601）在数值上也较低，但差异无统计学意义。我们的研究得出结论，在sICAS患者中，在21天内进行DCB血管成形术可能会带来更高程度的残留狭窄，并增加再狭窄的长期风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurotherapeutics 医学-神经科学

CiteScore

11.00

自引率

3.50%

发文量

154

审稿时长

6-12 weeks

期刊介绍： Neurotherapeutics® is the journal of the American Society for Experimental Neurotherapeutics (ASENT). Each issue provides critical reviews of an important topic relating to the treatment of neurological disorders written by international authorities. The Journal also publishes original research articles in translational neuroscience including descriptions of cutting edge therapies that cross disciplinary lines and represent important contributions to neurotherapeutics for medical practitioners and other researchers in the field. Neurotherapeutics ® delivers a multidisciplinary perspective on the frontiers of translational neuroscience, provides perspectives on current research and practice, and covers social and ethical as well as scientific issues.