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J Neurol Surg B Skull Base 2024; 85(05): 481-488
DOI: 10.1055/s-0043-1774791
Original Article

Clinical Study of Symptomatic Nonacute Intracranial Large Arterial Occlusion with Endovascular Recanalization

Bitang Dan‡   *
1   Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, People's Republic of China
,
Bifeng Zhu‡   *
2   Department of Neurology, The Third People's Hospital of Hubei Province, Jianghan University, Wuhan, Hubei, People's Republic of China
,
Wei Zeng
3   Department of Neurology, The Second Affiliated Hospital of Jianghan University, Fifth Hospital of Wuhan, Wuhan, Hubei, People's Republic of China
,
Tao Peng
2   Department of Neurology, The Third People's Hospital of Hubei Province, Jianghan University, Wuhan, Hubei, People's Republic of China
,
Jing Liu
2   Department of Neurology, The Third People's Hospital of Hubei Province, Jianghan University, Wuhan, Hubei, People's Republic of China
,
Xin Li
2   Department of Neurology, The Third People's Hospital of Hubei Province, Jianghan University, Wuhan, Hubei, People's Republic of China
,
Junjian Zhang
1   Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, People's Republic of China
› Institutsangaben Funding This work was supported by the Hubei Provincial Health Commission Guidance Project (WJ2019F177).
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Abstract

Objectives This study reported a single-center clinical trial of endovascular treatment for symptomatic nonacute occlusion of the intracranial large artery (NA-ILAO). The aim of this study was to evaluate the safety, feasibility, and clinical effect of simple balloon dilatation and stent implantation.

Methods The patients diagnosed with symptomatic NA-ILAO were enrolled. A total of 40 cases were included in this study. While recanalization failed in 4 patients, it was successful in 36 patients, who were then divided into two groups for further analysis: balloon dilatation group (n = 24) and stent implantation group (n = 12). The perioperative complications, clinical outcome, and follow-up results were analyzed.

Results Perioperative complications in the stent implantation group were significantly higher than those in the simple balloon dilatation group (p < 0.05). There were 21 and 10 cases of 90-day good clinical outcome (modified Rankin scale [mRS] ≤ 2) in the balloon and stent groups, respectively (p = 0.518). All patients with successful recanalization underwent digital subtraction angiography (DSA) or CT angiography (CTA) during an average follow-up of 14 months. There were two cases of restenosis in the balloon dilatation group and one in the stent implantation group (p = 1.000). There were two cases of re-occlusion in the stent group and none in the balloon dilatation group (p < 0.001). Stroke recurred in two cases in the stent group and in one case in the simple balloon dilatation group (p = 0.013).

Conclusion Endovascular recanalization is safe and feasible for patients with symptomatic NA-ILAO. Compared with stent implantation, simple balloon dilation may be a better recanalization method, but larger randomized controlled trials are needed to confirm it.

Keywords

nonacute intracranial large artery occlusion - endovascular recanalization - balloon dilatation - stent implantation

Ethical Approval and Consent to Participate

The study protocol was approved by the Ethics Committee of The Third People's Hospital of Hubei Province, Jianghan University. Informed consent was obtained from all the study subjects before enrollment.


Availability of Data and Material

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.


Author Contributions

B.D. contributed to the conception, design, and manuscript revision. B.Z. and T.P. collected the data and drafted the manuscript. W.Z. performed the data analysis and edited the manuscript. X.L. and J.L. collected all the data and revised the manuscript.


* Both the authors contributed equally to this study.




Publikationsverlauf

Eingereicht: 28. Oktober 2022

Angenommen: 17. August 2023

Artikel online veröffentlicht:
27. September 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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