Optimal timing of endovascular treatment for symptomatic intracranial atherosclerotic stenosis: a real world single center study

Objective: To determine the optimal timing of endovascular treatment for acute cerebral infarction with symptomatic intracranial atherosclerotic stenosis (sICAS) in real world practice. Methods: This retrospective single center study enrolled consecutive sICAS patients undergoing intervention. According to the interval from symptom onset to intervention, patients were divided into early (≤14 days) and delayed (>14 days) intervention groups. Primary outcomes were any stroke or death within 30 days and the 90-day mRS score. Secondary analyses explored factors influencing surgical timing. Results: = 0.033). Conclusion: In anterior circulation sICAS with minor stroke (NIHSS ≤ 3), high Alberta stroke program early CT score (ASPECTS)/posterior circulation ASPECTS (pcASPECTS) (8-9), and well-controlled LDL, intervention timing may not be restricted, whereas Basilar artery (BA) lesions appear better suited for delayed intervention. Multiple parallel severe stenoses, severe pre-existing global brain injury, and plaque high-signal intensity did not influence on the surgical timing. The conclusions of this study should be validated in future prospective studies.