Abstract DP228: Impact of Balloon Sizing and Procedural Factors in Emergent Angioplasty for Intracranial Atherosclerotic Large Vessel Occlusion

Background: Percutaneous transluminal angioplasty (PTA) is an established rescue option for intracranial atherosclerotic disease–related large-vessel occlusion (ICAD-LVO); however, the procedural factors influencing angiographic results, safety, and clinical outcomes remain uncertain. Objective: To identify procedural factors associated with residual stenosis, hemorrhagic complications, and clinical outcomes after emergency PTA for ICAD-LVO. Methods: We retrospectively analyzed consecutive patients with acute ischemic stroke who underwent PTA for ICAD-LVO at our center between 2015 and 2025. Target lesions were intracranial internal carotid artery, middle cerebral artery, vertebral artery, or basilar artery. Patient and procedural characteristics were collected. The balloon-to-vessel (BV) ratio was calculated as balloon diameter divided by parent-vessel diameter. The primary outcome was residual stenosis