Journal of NeuroInterventional Surgery最新文献

{"title":"Outcome prediction for treatment of brain arteriovenous malformations: performance of endovascular predictive scores in a single-center population.","authors":"Juan E Basilio Flores, Joel Aguilar-Melgar, Henry Pacheco-Fernandez Baca","doi":"10.1136/jnis-2024-022927","DOIUrl":"https://doi.org/10.1136/jnis-2024-022927","url":null,"abstract":"<p><strong>Background: </strong>Endovascular embolization is an accepted treatment modality for brain arteriovenous malformations (bAVM); however, treatment outcomes are highly variable, warranting accurate prediction for adequate patient selection. Several predictive scores have been proposed for this purpose. The objective of this study was to externally validate these scores for embolization of bAVM.</p><p><strong>Methods: </strong>This study involved bAVM patients treated with transarterial embolization. Endovascular predictive scores were identified through literature search. Relevant data for scoring of included patients was extracted. Primary study outcomes were radiological cure and neurological complications. The performance of the scores was evaluated by analyzing calibration (z-scores from logistic regression), discrimination (area under the receiver operating characteristic curve, AUROC), and classification (Youden's index and corresponding sensitivity and specificity). Additionally, sensitivity analyses were performed restricting the study population by size, location, and embolization intent.</p><p><strong>Results: </strong>A total of 198 bAVM (190 patients) were included. The rates of radiological cure and neurological complications were 18.2% and 14.1%, respectively. The literature search identified seven predictive scores. In the overall analysis, the Toronto score showed the best performance for radiological cure (AUROC 0.905). No significant difference was observed between the performance of the assessed scores for neurological complications. The sensitivity analysis showed improved performance of most scores. The Toronto score exhibited the highest performance for radiological cure (AUROC 0.857). The AVM Embolization Prognostic Risk Score (AVMEPRS) showed the highest performance for neurological complications (AUROC 0.751). The AVM Embocure Score (AVMES) showed fair to good performance for both efficacy and safety outcomes.</p><p><strong>Conclusion: </strong>Among the selected scores, the Toronto, AVMEPRS, and AVMES scores showed the best performances.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of antiplatelet medication discontinuation more than 12 months after stent-assisted coil embolization: a non-interventional, multicenter, observational study.","authors":"Chang Hyeun Kim, Young Hoon Choi, Jae Sang Oh, Youngsoo Kim, Jong Kook Rhim, Jong Hyeon Mun, Jeongwook Lim, Jeongjun Lee, Hyun Ho Choi, Eun-Oh Jeong, Mun Chul Kim, Young Ha Kim, Sang Weon Lee, Young Dae Cho","doi":"10.1136/jnis-2024-023003","DOIUrl":"https://doi.org/10.1136/jnis-2024-023003","url":null,"abstract":"<p><strong>Background: </strong>Antiplatelet maintenance is essential to avoid ischemia following stent-assisted coiling (SAC) procedures. However, indications for antiplatelet medication discontinuation (AMD) remain controversial, and optimal timing of cessation has yet to be determined. Our goal, which we achieved through a multicenter, prospectively enrolled, non-interventional study, was to investigate the safety of AMD conducted more than 12 months after SAC.</p><p><strong>Methods: </strong>Data were retrieved from the records of 495 consecutive patients prospectively enrolled at 10 institutions during a 3-year period (between January 2021 and December 2023). Each subject had discontinued antiplatelet therapy >12 months after SAC. Maintenance duration and cessation were both at physician discretion, based on patient clinical status. We investigated clinical outcomes for at least 6 months after AMD.</p><p><strong>Results: </strong>A majority of patients engaged in AMD (292/495, 59.0%) were not at high risk for ischemia. Mean±SD time to AMD was 20.0±12.9 months after SAC. Treated aneurysms were largely confined to the internal carotid artery (332/495, 67.1%), followed by the anterior (95/495, 19.2%) and middle (43/495, 8.7%) cerebral arteries. A laser-cut open-cell stent was most often applied (60.5%); laser-cut closed-cell (22.2%) and braided closed-cell (17.3%) stents were used to a lesser extent. Four patients underwent double stenting. Despite sizeable (41.0%) high-risk group representation, there were no ischemic events in relation to AMD.</p><p><strong>Conclusion: </strong>Our results suggest that AMD >12 months after SAC procedures is safe in patients who are not at high risk for ischemia. Randomized controlled trials are warranted to confirm these results.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computational flow dynamics of a novel next-generation flow diverter.","authors":"Madison M Patrick, Sandhya Santhanaraman, Jayendiran Raja, Alexander L Coon, Geoffrey P Colby, Jessica K Campos, Matthew Lawson, Narlin B Beaty","doi":"10.1136/jnis-2024-022705","DOIUrl":"https://doi.org/10.1136/jnis-2024-022705","url":null,"abstract":"<p><strong>Background: </strong>Flow-diverting stents (FDS) have revolutionized the treatment of large, giant, and wide-neck intracranial aneurysms. FDS promote thrombosis and aneurysm occlusion by redirecting blood flow within the parent artery. This method of endovascular therapy has proven efficacious, although leaving room for improvement. This study evaluated computational flow dynamics (CFD) and technical feasibility of the novel Surpass Elite FDS (Elite) in comparison with the Pipeline Embolization Device with Shield Technology (PED-Shield) across seven in vitro aneurysm models.</p><p><strong>Methods: </strong>Surpass Elite FDS and PED-Shield were assessed primarily with three CFD metrics to quantify flow diversion: inflow rate reduction, impact zone reduction, and turnover time. Seven patient-specific aneurysm models were utilized. These included one basilar tip, one vertebral artery, two middle cerebral artery, and three internal carotid artery aneurysms. Further evaluation of pore densities and velocity profiles was performed to create a robust comparison summary.</p><p><strong>Results: </strong>Surpass Elite FDS demonstrated greater reduction in inflow rate and impact zone with improved turnover time in all models. Elite additionally displayed higher pore densities at nearly all proximal (inlet), aneurysm, and distal (outlet) points across the aneurysm models.</p><p><strong>Conclusions: </strong>The next-generation Surpass Elite established better CFD metrics in comparison with PED-Shield in all in vitro aneurysm models evaluated here. Further, Elite demonstrated a higher pore density at nearly all aneurysm points assessed in this study, promoting enhanced flow diversion and thrombosis in the aneurysm sac. Considering these findings, Elite has strong potential to improve on the occlusion rates of PED-Shield.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of baseline infarct size, reperfusion grade and intracranial hemorrhage in patients undergoing thrombectomy.","authors":"Alexander Stebner, Salome Lou Bosshart, Satoru Fujiwara, Donald Frei, Jason Tarpley, Dariush Dowlatshahi, Jeremy L Rempel, Michael D Hill, Mayank Goyal, Johanna M Ospel","doi":"10.1136/jnis-2025-023103","DOIUrl":"https://doi.org/10.1136/jnis-2025-023103","url":null,"abstract":"<p><strong>Background: </strong>Better reperfusion status results in smaller infarct volumes and better outcomes after thrombectomy. However, if large tissue volumes are already infarcted at baseline, reperfusion might also increase the risk of intracranial hemorrhage. This study aims to investigate the interaction between reperfusion status, baseline ischemic changes, and intracranial hemorrhage following thrombectomy.</p><p><strong>Methods: </strong>Retrospective analysis of the ESCAPE-NA1 randomized trial. Unadjusted and adjusted logistic regression models were used to estimate the associations of Alberta Stroke Program Early CT Score (ASPECTS) and expanded Treatment In Cerebral Infarction (eTICI) score on post-treatment hemorrhage. Treatment effect modification was assessed by including multiplicative interaction terms (ASPECTS*eTICI) in these models.</p><p><strong>Results: </strong>A total of 1077 patients were included. Median age was 70.8 (IQR 60.7-79.7) and 543 (50.4%) were female. Any intracranial hemorrhage on 24-hour follow-up imaging occurred in 368/1077 (34.2%) patients. There was evidence of modification of the effect of final angiogram eTICI score on any intracranial hemorrhage by baseline ASPECTS (P=0.008). Marginal probabilities showed increased hemorrhage risk for patients with low ASPECTS with increasing final eTICI scores. This association was reversed in patients with small baseline ischemic changes and successful reperfusion. There was no association with symptomatic intracranial hemorrhage or parenchymal hematoma.</p><p><strong>Conclusion: </strong>The association of post-thrombectomy reperfusion status and post-treatment hemorrhage may be modified by the extent of baseline ischemia. Reperfusion is associated with reduced risk of hemorrhage in patients with small baseline infarcts, but increased hemorrhage risk in patients with extensive ischemic changes at baseline. However, no significant association was found with symptomatic intracranial hemorrhage or parenchymal hematoma.</p><p><strong>Trial registration number: </strong>NCT02930018.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between dehydration trajectory, delayed cerebral ischemia, and functional outcome in patients with aneurysmal subarachnoid hemorrhage: assessment of interaction and mediation.","authors":"Peng Zhang, Qi Tu, Minfeng Tong, Kefeng Shi, Tingyu Yang, Jiale Wang, Weizhong Zhang, Qi Pang, Zequn Li, Zhijian Xu","doi":"10.1136/jnis-2024-022953","DOIUrl":"https://doi.org/10.1136/jnis-2024-022953","url":null,"abstract":"<p><strong>Background: </strong>Blood urea/creatinine (U/Cr) ratio is considered to be an ideal biomarker of dehydration. We investigated the association between the U/Cr ratio trajectory and delayed cerebral ischemia (DCI) as well as functional outcome in aneurysmal subarachnoid hemorrhage (aSAH). Additionally, we explored the role of DCI as a mediator and its interaction with dehydration.</p><p><strong>Methods: </strong>Consecutive aSAH patients were reviewed. A latent class growth mixture model (LCGMM) was applied to classify the dehydration trajectory over 7 days. Multivariate logistic regression was conducted to examine associations between dehydration trajectories, DCI, and poor outcome. Furthermore, causal mediation analysis combined with a four-way decomposition approach was employed to quantify the extent to which DCI mediates or interacts with dehydration in influencing poor outcomes.</p><p><strong>Results: </strong>A total of 519 aSAH patients were included. By applying the LCGMM method, we categorized participants into three dehydration trajectory groups: low group (n=353), decreasing group (n=97), and high group (n=69). Multivariate analysis demonstrated that dehydration trajectory was independently associated with both DCI and poor outcome. The effect of dehydration trajectory on poor outcome was partially mediated by DCI, involving both pure mediation and mediated interaction. Specifically, the excess relative risk of DCI was decomposed into four components: controlled direct effect (66.42%), mediation only (16.35%), interaction only (6.09%), and mediated interaction (11.16%).</p><p><strong>Conclusion: </strong>Among aSAH patients, dehydration trajectory was significantly associated with poor functional outcome, with DCI serving as a partial mediator through both direct and interaction effects.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of carotid artery stenting with open- versus closed-cell stents.","authors":"Guilin Zhang, Dongqiao Xiang, Haohao Lu, Fu Xiong, Yanyan Cao, Ling Xiang, Chuansheng Zheng, Xuefeng Kan","doi":"10.1136/jnis-2025-023058","DOIUrl":"https://doi.org/10.1136/jnis-2025-023058","url":null,"abstract":"<p><strong>Background: </strong>The stent type may be associated with adverse events in carotid artery stenting (CAS). This study aimed to compare the clinical outcomes (stroke/myocardial infarction (MI)/death) of CAS with open- and closed-cell stents for patients with carotid artery stenosis.</p><p><strong>Methods: </strong>Between April 2012 and May 2024, the clinical data of 223 patients who underwent CAS in our center were retrospectively analyzed. In terms of the stent type used, patients were divided into a closed-cell stent group and an open-cell stent group. Clinical outcomes between the two groups were compared. Univariate and multivariate analyses were performed to identify the independent risk factors. Subgroup analyses in terms of carotid plaque types and smoking history were conducted in carotid artery stenosis patients receiving CAS with open- and closed-cell stents.</p><p><strong>Results: </strong>The combined in-hospital stroke/MI/death rate was significantly lower in the closed-cell stent group than in the open-cell stent group (p=0.026). Open-cell stents, smoking, and unstable plaques were the independent risk factors associated with a higher in-hospital stroke/MI/death rate. Subgroup analyses showed that for patients with unstable plaques, the combined in-hospital stroke/MI/death rate was significantly higher in the open-cell stent group than in the closed-cell stent group (p=0.016). For patients who smoked, the combined in-hospital stroke/MI/death rate was significantly higher in the open-cell stent group than in the closed-cell stent group (p=0.038).</p><p><strong>Conclusion: </strong>For carotid artery stenosis patients with unstable carotid plaques or smoking history, using closed-cell stents in CAS may help reduce the combined in-hospital stroke/MI/death rate.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of first pass effect in mechanical thrombectomy for vertebrobasilar artery occlusion: a comprehensive meta-analysis of prevalence, outcomes, and predictive factors.","authors":"Lei Guo, Jun Zhang, Jianhong Wang, Shu Yang, Yang Xiang, Fuqiang Guo","doi":"10.1136/jnis-2024-022960","DOIUrl":"10.1136/jnis-2024-022960","url":null,"abstract":"<p><strong>Background: </strong>First-pass effect (FPE) is crucial for better outcomes in mechanical thrombectomy (MT) for acute large vessel occlusions. However, its frequency and predictors in vertebrobasilar artery occlusion (VBAO) remain unclear.</p><p><strong>Objective: </strong>To conduct a comprehensive systematic review and meta-analysis to assess the incidence of FPE in MT for VBAO and its impact on key clinical outcomes. Additionally, to explore potential predictors of achieving FPE, addressing critical knowledge gaps and providing evidence to optimize treatment strategies for patients with VBAO.</p><p><strong>Methods: </strong>A systematic literature search was performed in PubMed, EMBASE, Web of Science, and the Cochrane Library up to November 1, 2024. Studies evaluating FPE in patients with acute VBAO undergoing MT were included. The prevalence of FPE was estimated using a meta-analysis of proportions, and associations with clinical outcomes and predictive factors were assessed using pooled ORs with random-effects models.</p><p><strong>Results: </strong>Twenty studies involving 4315 patients met inclusion criteria. The overall prevalence of FPE in patients with VBAO was 41% (95% CI 33% to 50%). FPE was significantly associated with improved 90-day outcomes (modified Rankin Scale (mRS) score 0-2: OR=2.00, 95% CI 1.45 to 2.75; mRS score 0-3: OR=2.33, 95% CI 1.78 to 3.04), reduced risk of symptomatic intracranial hemorrhage (OR=0.49, 95% CI 0.27 to 0.87), and lower mortality (OR=0.43, 95% CI 0.32 to 0.57). The results showed that significant positive predictors of FPE included female sex, atrial fibrillation, cardioembolic or unknown stroke etiology, mid- or distal basilar artery occlusion, contact aspiration techniques, and the use of larger catheters. Conversely, negative predictors were identified as a history of hypertension, hyperlipidemia, prior stroke or transient ischemic attack, higher baseline NIHSS scores, prolonged procedure time, and the use of general anesthesia.</p><p><strong>Conclusion: </strong>Achieving FPE in acute VBAO is strongly associated with improved clinical outcomes. Important clinical, procedural, and anatomical factors related to FPE were identified, aiding clinical decisions and thrombectomy techniques.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First reported series of intracranial and carotid aneurysm embolization performed at an ambulatory neurosurgery center: preliminary experience.","authors":"Pui Man Rosalind Lai, Kenneth V Snyder, Elad I Levy","doi":"10.1136/jnis-2025-023228","DOIUrl":"https://doi.org/10.1136/jnis-2025-023228","url":null,"abstract":"<p><strong>Background: </strong>Intracranial aneurysm embolization is traditionally performed in a hospital setting, but there is growing interest in transforming these procedures to outpatient facilities, while ensuring patient safety and effectiveness. We present the first series of patients undergoing flow diverting embolization at an ambulatory neurosurgery center (ANSC) and assessed feasibility, safety, and patient satisfaction.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of patients undergoing flow diverting embolization at the ANSC between August 1, 2024, and January 3, 2025. Patient demographics, procedural details, and periprocedural events were recorded. Patients were observed at the ANSC before transfer to a rehabilitation facility for overnight monitoring in a simulated home environment. A postprocedural satisfaction survey (scale 0-5; 5=best experience) was completed at the 2 week follow-up.</p><p><strong>Results: </strong>Nine patients (mean age 55±13 years) underwent embolization under conscious sedation. Eight aneurysms in the internal carotid artery (mean aneurysm size 6.3±2.8 mm) and one cervical pseudoaneurysm were treated using the Pipeline Vantage (Medtronic, Dublin, Ireland) via a transfemoral approach. Mean procedural time was 35±1 min; mean turnover time was 17±0.2 min. No periprocedural or delayed complications occurred. Patients were observed for a mean 5.3±1.5 hours in the ANSC and discharged home from rehabilitation on postprocedure day 1. Patient satisfaction was unanimously rated 5.</p><p><strong>Conclusions: </strong>The results showed that flow diverting embolization for aneurysms can be safely and feasibly performed in the outpatient setting with careful patient selection and use of the latest generation flow diverters. An ANSC may offer meaningful benefits, including reducing hospital burden, lower costs, and improvement of overall efficiency, while maintaining patient safety and quality.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contour neurovascular system: have we sufficient clinical data to use it in current clinical practice?","authors":"Laurent Pierot, Laurent Spelle","doi":"10.1136/jnis-2024-022517","DOIUrl":"10.1136/jnis-2024-022517","url":null,"abstract":"","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"447-448"},"PeriodicalIF":4.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of calcium channel blockers on perioperative ischemic events in hypertensive patients with intracranial aneurysms undergoing neurointervention.","authors":"Qichen Peng, Yangyang Zhou, Chao Wang, Xuanping Xie, Linggen Dong, Yisen Zhang, Hongqi Zhang, Jun Wang, Liang Li, Pinyuan Zhang, Yuanli Zhao, Yang Wang, Fushun Xiao, Bin Luo, Wenqiang Li, Shiqing Mu","doi":"10.1136/jnis-2024-021543","DOIUrl":"10.1136/jnis-2024-021543","url":null,"abstract":"<p><strong>Background: </strong>Although calcium channel blockers (CCBs) are useful in stroke prevention, their specific role in preventing stroke in hypertensive patients with intracranial aneurysms undergoing endovascular stent placement remains unclear.</p><p><strong>Methods: </strong>We retrospectively examined 458 hypertensive patients with intracranial aneurysms who underwent stent treatment, drawn from a larger multicenter cohort comprising 1326 patients across eight centers. Patients were dichotomized into two groups according to use of a CCB. Propensity score matching (PSM) was performed to balance group differences in patient and aneurysm characteristics. We conducted a comparison of patient and aneurysm characteristics, ischemic complications, and clinical outcomes between the two groups.</p><p><strong>Results: </strong>The CCB and non-CCB groups comprised 279 and 179 patients, respectively. PSM resulted in 165 matched pairs. After PSM, the incidence of ischemic events within 1 month of the procedure (4.2% vs 10.9%; P=0.022) and proportion of patients with modified Rankin Scale score >2 at last follow-up (1.5% vs 7.8%; P=0.013) were significantly lower in the CCB group. Among patients treated with combination therapy, inclusion of a CCB was associated with a lower incidence of ischemic events (1.5% vs 13.3%; P=0.345), but the difference was not statistically significant after correction.</p><p><strong>Conclusions: </strong>CCB use in hypertensive patients undergoing endovascular stenting for treatment of intracranial aneurysms is associated with a lower incidence of ischemic events and a lower incidence of unfavorable neurological outcomes, especially when used in combination therapy.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"375-381"},"PeriodicalIF":4.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140288312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}