Outcomes of Treating Symptomatic Intracranial Stenosis With Angioplasty or Stent Placement: A Retrospective Study in a Cohort of 37 Patients

Background Intracranial atherosclerotic disease (ICAD) is a leading cause of ischemic stroke worldwide, with endovascular interventions such as angioplasty and stenting facing scrutiny due to variable safety outcomes in prior studies. Objective This study aimed to assess the safety of angioplasty with or without stenting for symptomatic ICAD and evaluate the predictors of procedural complications, including intervention timing, stenosis location, and clinical severity. Method In this retrospective analysis, 37 patients with symptomatic ICAD (70-99% stenosis) underwent angioplasty with stenting (n=32) or angioplasty alone (n=5). Patients were stratified into two groups: acute (≤7 days post-symptom onset) and semi-acute (>7 days post-symptom onset). Complications were assessed at 72 hours and 30 days. Results Technical revascularization succeeded in 36/37 cases (97.3%). Six patients (16.2%) experienced complications (all occurred in the acute group), including three deaths and three new neurological deficits within 72 hours. Angioplasty alone (all acute) had a 40% complication rate versus 19% with stenting (OR=0.35; p=0.29). Although numerically higher in acute versus subacute cases (28.6% vs. 0%), neither timing (p=0.16) nor posterior versus anterior circulation (p=1.0) reached statistical significance. Conclusion In this cohort, intervention timing, vascular territory, and patient demographics had no significant impact on complication rates. Technical success of intracranial angioplasty and stenting exceeded 97%, with no association between acute procedures or posterior lesions and poorer outcomes. These null results should be viewed in light of the limited sample size. Overall, endovascular revascularization proved feasible across varied patient subgroups.