Dong Kaiyue, Chen Yingkun, Song Yun, Sun Lili, Zheng Meimei, Yin Hao, Zhang Jun, Li Shuoshuo, Yin Tianxi, Wang Wei, Meng Yao, Li Weili, He Xiao, Zhu Chenlu, Zhao Wei, Han Ju
Department of Neurology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China.
Front Neurol. 2025 Aug 15;16:1570728. doi: 10.3389/fneur.2025.1570728. eCollection 2025.
Non-acute intracranial artery occlusion (ICAO) is an important cause of recurrent ischemic stroke despite aggressive medical treatment. Conventional angioplasty has high incidences of perioperative complications and restenosis in treating these patients. Drug-coated balloon (DCB) treatment has shown superiority in preventing restenosis. This study aimed to compare the DCB angioplasty with conventional angioplasty in symptomatic ICAO patients.
From January 2016 to March 2024, consecutive patients with symptomatic non-acute ICAO treated with endovascular therapy were enrolled and dichotomized by whether DCB was used. Propensity score matching analysis was used to compare the perioperative complications, clinical and imaging follow-up results of the two groups.
158 eligible patients were included in this study. There were 104 cases in the DCB group and 54 cases in the non-DCB group. A total of 92 matched patients were selected for propensity score matching analysis. At 6 months follow-up, the median stenosis degree (19.3% [0% ~ 34.3%] vs. 43.6% [22.8% ~ 80.2%], = 0.009) and total restenosis incidence (10.9% [5/46] vs. 39.1% [18/46], = 0.004) were significantly lower in the DCB group. There were no statistically significant differences in the incidences of perioperative complications (8.7% vs. 17.4%, = 0.388), symptomatic restenosis (2.2% vs. 8.7%, = 0.375) and recurrent ischemic events (4.3% vs. 10.9%, = 0.453) between the two groups.
In patients with symptomatic non-acute ICAO, compared with conventional angioplasty, DCB angioplasty can effectively reduce the restenosis degree and restenosis risk.
尽管进行了积极的药物治疗，但非急性颅内动脉闭塞（ICAO）仍是复发性缺血性卒中的重要原因。传统血管成形术在治疗这些患者时围手术期并发症和再狭窄发生率较高。药物涂层球囊（DCB）治疗在预防再狭窄方面已显示出优势。本研究旨在比较症状性ICAO患者中DCB血管成形术与传统血管成形术的疗效。
2016年1月至2024年3月，纳入连续接受血管内治疗的症状性非急性ICAO患者，并根据是否使用DCB进行二分法分组。采用倾向评分匹配分析比较两组的围手术期并发症、临床和影像学随访结果。
本研究共纳入158例符合条件的患者。DCB组104例，非DCB组54例。共选择92例匹配患者进行倾向评分匹配分析。随访6个月时，DCB组的中位狭窄程度（19.3%[0%34.3%]对43.6%[22.8%80.2%]，P = 0.009）和总再狭窄发生率（10.9%[5/46]对39.1%[18/46]，P = 0.004）显著更低。两组围手术期并发症发生率（8.7%对17.4%，P = 0.388）、症状性再狭窄发生率（2.2%对8.7%，P = 0.375）和复发性缺血事件发生率（4.3%对10.9%，P = 0.453）差异均无统计学意义。
在症状性非急性ICAO患者中，与传统血管成形术相比，DCB血管成形术可有效降低再狭窄程度和再狭窄风险。
