The application of the intracranial arterial drug-eluting stent DES-NOVA in intracranial atherosclerotic stenosis-related emergent large vessel occlusion.

Abstract

This study aims to evaluate the clinical effectiveness of intracranial artery drug-eluting stent (DES-NOVA) in patients with intracranial atherosclerotic stenosis (ICAS)-related emergent large vessel occlusion (ELVO), explore their safety and short-term prognosis, and provide a basis for optimizing the endovascular treatment strategy for ICAS-ELVO. The clinical data of 32 patients with ICAS-ELVO who underwent emergency endovascular treatment with DES-NOVA stent implantation were retrospectively analyzed. We observed the post-procedural revascularization rate (mTICI ≥ grade 2b), the degree of target vessel stenosis, and peri-procedural complications. Additionally, we performed clinical and imaging follow-up at 30 days and approximately 6 months postoperatively to assess prognosis and in-stent restenosis (ISR) rate. DES-NOVA stents were successfully implanted in all 32 patients (100% technical success rate), with a significant reduction in culprit vessel stenosis from a median of 85% to 5% post-procedure (P < 0.001). The 30-day perioperative adverse event rate was 9.3%, with acute in-stent thrombosis, symptomatic intracranial hemorrhage, and death each occurring in 1 patient (3.1% per event). Angiographic follow-up was completed in 28 of 31 surviving patients (90%), showing an in-stent restenosis rate of 3.6% (95% CI: 0.1%-19%). Sensitivity analysis for 3 lost patients yielded an adjusted range of 3.2%-13%. No new ischemic events or deaths occurred after the 30-day perioperative period. In this selected cohort of patients with ICAS-ELVO, emergency DES-NOVA stent placement demonstrated high technical feasibility and a low ISR rate among those with angiographic follow-up. These preliminary findings warrant prospective validation.