Efficacy and safety of balloon dilation versus stent implantation in young ischemic stroke patients with symptomatic intracranial artery stenosis

Objective To compare the efficiency and safety between balloon dilation and stent implantation in young ischemic stroke patients with symptomatic intracranial artery stenosis (ICAS). Methods Total 37 young ischemic stroke patients who received endovascular treatment in Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School from February 2019 to February 2023 were enrolled. According to the Mori classification and the location of the lesions, balloon dilation was performed in 12 cases and stent implantation was performed in 25 cases. The primary outcomes were vascular restenosis rate, stroke recurrence rate and mortality events during the follow-up period (3-12 months after operation), and the secondary outcomes were the surgical success rate and the peri⁃operative complications rate. Results For the primary outcomes, after an average follow⁃up of (5.21±2.19) months, among the 36 patients who completed the follow-up, 6 cases (16.67%) had vascular restenosis, with 2 cases (2/12) in balloon dilation group and 4 cases (16.67%) in stent implantation group. There was no statistically significant difference between the 2 groups (Fisher's exact probability: P=1.000). No stroke recurrence or mortality events occurred. For the secondary outcomes, the surgical success rate reached 100% (37/37). Three cases (8.11%) experienced peri⁃operative complications, with one case (1/12) in balloon dilation group and 2 cases (8%) in stent implantation group. There was no statistically significant difference between the 2 groups (Fisher's exact probability: P=1.000). No thrombosis occurred within the stent or the diseased blood vessels. Conclusions For young ischemic stroke patients with ICAS, the efficacy and safety of balloon dilation and stent implantation are comparable. Further exploration through multicenter, large⁃sample clinical trials are needed.