A112 Angioplasty versus angioplasty plus stenting for underlying atherosclerotic stenosis in acute large vessel occlusion

<h3>Introduction</h3> The optimal treatment strategy for patients with acute large vessel occlusion (LVO) due to underlying intracranial atherosclerotic stenosis is unclear. <h3>Aim of Study</h3> The purpose of this study was to investigate the safety and efficacy of angioplasty and angioplasty plus stenting for underlying atherosclerotic stenosis in such patients. <h3>Method</h3> From January 2010 to June 2022, a total of 168 patients underwent angioplasty without and with stenting for the rescue therapy of underlying atherosclerotic stenosis during endovascular treatment for acute LVO in the anterior and posterior circulations. All patient underwent follow up CT angiography during hospitalization. Procedure-related complications and clinical outcomes were compared between 2 groups. A patency of treated artery was assessed with follow up CT angiography for the assessment of restenosis of the treated artery, early reocclusion, and luminal gain with positive remodeling. <h3>Results</h3> Among patients, 63 underwent angioplasty alone and 105 received angioplasty plus stenting. Instant reocclusion occurred in 11.3% during the procedure. Extravasation occurred in 2 stenting cases, and subarachnoid hemorrhage was found in 17.3% on follow-up CT. Procedure-related complication rates were not different between 2 groups. However, suboptimal angiographic results were more frequent in the angioplasty group (34.9% vs. 17.1%, p=0.009), while luminal gain was more common with stenting (22.9% vs. 9.5%, p=0.004). No significant differences were observed in early reocclusion, symptomatic hemorrhage, or favorable clinical outcome. <h3>Conclusion</h3> Both angioplasty alone and angioplasty with stenting appear safe and effective for treating underlying atherosclerotic stenosis in acute stroke patients with LVO. Additional stenting may offer improved arterial patency following angioplasty in this population. <h3>Conflict of Interest</h3> No