{
  "abstract": "Background Intracranial atherosclerotic stenosis (ICAS) is a major cause of ischemic stroke, particularly in Asian populations. Although aggressive medical therapy is the standard first-line treatment, patients with severe stenosis remain at risk of recurrent ischemic events. Endovascular treatment, including balloon angioplasty with or without stenting, has been selectively used in patients with symptomatic ICAS and recurrent stroke despite medical therapy.Methods We retrospectively reviewed consecutive patients who underwent endovascular treatment for symptomatic anterior circulation ICAS at a single center. Patients were included if they had ≥70% stenosis involving the distal intracranial internal carotid artery (ICA) or MCA M1 segment and experienced recurrent ischemic stroke despite aggressive medical therapy, including dual antiplatelet therapy and high-intensity statin treatment. In selected cases, treatment was also performed for progressive neurological deterioration during the acute stroke period. Endovascular treatment consisted of balloon angioplasty alone or angioplasty with stent placement at the operator’s discretion. Clinical outcomes included 30-day and 12-month ischemic stroke and restenosis ≥50% on vascular imaging at approximately 12 months.Results A total of 48 patients were included (mean age 65.7 ± 10.8 years, 63% male). Lesions involved the distal ICA (n=26) and MCA M1 segment (n=21), with one ACA lesion. Balloon angioplasty alone was performed in 13 patients, while 35 underwent angioplasty with stent placement, most commonly using the Enterprise stent. Follow-up vascular imaging at approximately 12 months was available in 41 patients (85%). Thirty-day ischemic stroke occurred in 2 patients (4.2%), with one additional ischemic stroke during 12-month follow-up. Among patients who underwent follow-up imaging, restenosis of 50% or greater was observed in six individuals (15%), including two symptomatic cases.Conclusions Balloon angioplasty with or without stenting showed acceptable periprocedural safety and relatively low restenosis rates in patients with symptomatic anterior circulation ICAS. Further studies are needed to determine optimal patient selection and treatment strategies.Disclosures K. Seo: None. M. Sung: None. S. Suh: None.",
  "authors": [
    {
      "affiliations": [
        "Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of"
      ],
      "name": "K Seo"
    },
    {
      "affiliations": [
        "Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of"
      ],
      "name": "M Sung"
    },
    {
      "affiliations": [
        "Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of"
      ],
      "name": "S Suh"
    }
  ],
  "title": "E-328 Outcomes after balloon angioplasty with or without stenting for symptomatic anterior circulation intracranial atherosclerotic stenosis",
  "uid": "322d1410-2af6-5da9-85fd-52da9dfcc0f8"
}