Table_1_Percutaneous angioplasty and/or stenting versus aggressive medical therapy in patients with symptomatic intracranial atherosclerotic stenosis: a 1-year follow-up study.docx

BackgroundSymptomatic intracranial atherosclerotic stenosis (sICAS) is one of the common causes of ischemic stroke. However, the treatment of sICAS remains a challenge in the past with unfavorable findings. The purpose of this study was to explore the effect of stenting versus aggressive medical management on preventing recurrent stroke in patients with sICAS.
MethodsWe prospectively collected the clinical information of patients with sICAS who underwent percutaneous angioplasty and/or stenting (PTAS) or aggressive medical therapy from March 2020 to February 2022. Propensity score matching (PSM) was employed to ensure well-balanced characteristics of two groups. The primary outcome endpoint was defined as recurrent stroke or transient ischemic attack (TIA) within 1 year.
ResultsWe enrolled 207 patients (51 in the PTAS and 156 in the aggressive medical groups) with sICAS. No significant difference was found between PTAS group and aggressive medical group for the risk of stroke or TIA in the same territory beyond 30 days through 6 months (P = 0.570) and beyond 30 days through 1 year (P = 0.739) except for within 30 days (P = 0.003). Furthermore, none showed a significant difference for disabling stroke, death and intracranial hemorrhage within 1 year. These results remain stable after adjustment. After PSM, all the outcomes have no significant difference between these two groups.
ConclusionThe PTAS has similar treatment outcomes compared with aggressive medical therapy in patients with sICAS across 1-year follow-up.

背景：有症状颅内动脉粥样硬化性狭窄（symptomatic intracranial atherosclerotic stenosis, sICAS）是缺血性脑卒中的常见病因之一。然而长期以来，sICAS的治疗仍为临床难题，既往相关研究结果并不理想。本研究旨在探讨支架置入术与强化药物治疗在预防sICAS患者卒中复发方面的效果。
方法：本研究前瞻性收集了2020年3月至2022年2月期间，接受经皮血管成形术和/或支架置入术（percutaneous angioplasty and/or stenting, PTAS）或强化药物治疗的sICAS患者的临床资料。采用倾向得分匹配（propensity score matching, PSM）法以确保两组患者的基线特征均衡可比。本研究的主要结局终点定义为1年内发生复发性卒中或短暂性脑缺血发作（transient ischemic attack, TIA）。
结果：本研究共纳入207例sICAS患者，其中PTAS组51例，强化药物治疗组156例。在30天之后至6个月（P=0.570）、30天之后至1年（P=0.739）的同一供血区域卒中或TIA风险方面，两组未观察到显著统计学差异，但30天内的风险存在显著差异（P=0.003）。此外，1年内致残性卒中、死亡及颅内出血的发生率在两组间均无显著差异。上述结果经校正后仍保持稳定。经倾向得分匹配后，两组的各项结局指标均无显著差异。
结论：在1年随访周期内，经皮血管成形术和/或支架置入术与强化药物治疗用于sICAS患者的治疗效果相当。