Short- and long-term outcomes of stenting for symptomatic intracranial arterial stenosis: a cohort study

Abstract Background Ischemic stroke ranks as the second leading cause of mortality globally and the third major contributor to disability. Intracranial atherosclerotic stenosis (ICAS) represents a significant cause of stroke and is linked to an elevated risk of recurrence despite medical treatment. This study aimed to assess both the short- and long-term outcomes of stenting in patients with symptomatic intracranial arterial stenosis. This observational prospective study was carried out on 43 patients with symptomatic intracranial atherosclerotic disease that underwent stenting. Results From findings of our results, we found that regarding short-term outcome, there was only one case that was complicated by secondary brain stem hemorrhage after basilar stenting. Regarding long-term outcome, there were four cases that showed unfavorable outcomes (two of them complicated with TIA, and two cases had cerebral infarction). We found only four cases: 4/34 (11.8%) had restenosis. The modified Rankin Scale (mrs) and National Institutes of Health Stroke Scale (NIHHS) scales decreased at 1 year follow-up when compared to pre-operative and after 1 month follow-up. Patients with unfavorable and favorable outcomes in short-term follow-up differ significantly in their preoperative NIHSS scores. A significant increase in the association of unfavorable outcomes in long-term follow-up with diabetes and hyperlipidemia. By logistic regression, hyperlipidemia was found to be an associated factor that contributed to unfavorable outcomes. Conclusions Patients with severe symptomatic ICAS who received specifically designed stenting may experience a low percentage of side effects. Our findings imply that endovascular therapy for ICAD remains a good option; however, further large-scale research is required to confirm its efficacy in preventing recurrent stroke in patients with high-grade symptomatic intracranial stenosis. The long-term clinical results of intracranial stenting may be enhanced by careful patient selection and technological advancements in the devices used.