Abstract
Patients with symptomatic intracranial arterial stenosis (sICAS) will likely face perioperative risks with stent placement and recurrence with medication. Simple balloon angioplasty (SBA), as a less invasive and safer alternative to stent placement, may offer an effective treatment option for sICAS. This study aimed to assess the perioperative safety of SBA compared to medication for sICAS. A retrospective analysis was conducted on sICAS patients admitted to the Department of Neurology, Jiangxi Provincial People's Hospital, between January 2020 and December 2021, within 60 days of onset. Patients with severe stenosis (70% to 99% rate), confirmed by cerebral angiography, were divided into medication and SBA groups. Demographic data, medical history, NIH Stroke Scale (NIHSS) scores at onset, responsible vessels, degree of vascular stenosis, postoperative residual stenosis rate, and any stroke or death within 30 days postoperatively were assessed. The study included 91 patients, with 51 in the medication group (38 males, mean age 58.06±1.58 years) and 40 in the SBA group (24 males, mean age 60.95±1.37 years). There were no significant differences in demographics, medical history, NIHSS scores, or degree of vascular stenosis (all P > 0.05). All SBA patients underwent successful balloon angioplasty, with 8 cases (20%) requiring a stent placement due to significant post-dilation stenosis regression or dissection affecting blood flow. Within 30 days postoperatively, 2 patients (3.9%) in the medication group experienced progressive stroke, while 3 patients (7.5%) in the SBA group experienced endpoint events, including 2 cases of new-onset infarction and 1 case of subarachnoid hemorrhage. There was no statistically significant difference in endpoint event occurrence between the groups (P > 0.05), and no deaths occurred. In conclusion, SAB in sICAS patients did not significantly increase the risk of stroke within 30 days postoperatively compared to medication treatment. Long-term efficacy warrants further investigation.