Language
English
Publication Date
5-13-2025
Journal
Interventional Neuroradiology
DOI
10.1177/15910199251339538
PMID
40356420
PMCID
PMC12075157
PubMedCentral® Posted Date
5-13-2025
PubMedCentral® Full Text Version
Post-print
Abstract
Background
Intracranial atherosclerotic disease (ICAD) is a leading cause of ischemic stroke. The Medtronic Resolute Onyx Zotarolimus-eluting stents (RO-ZES) are promising in preventing stroke recurrence compared with medical management (MM) and percutaneous angioplasty and stenting (PTAS) at both 30-day and one-year follow-ups. We evaluated long-term outcomes for patients treated with RO-ZES, PTAS, or MM.
Methods
A retrospective multicenter study was conducted including patients who underwent RO-ZES stenting for symptomatic ICAD between March 2018 and May 2023, with follow-up through October 2024. Propensity score-matched control groups, representing MM and PTAS, were derived from the SAMMPRIS trial. Primary outcomes included recurrence rates of transient ischemic attack, stroke, intracerebral hemorrhage (ICH), and mortality. Time-to-event after intervention was evaluated.
Results
Patients who underwent stenting with RO-ZES and two propensity-matched cohorts from the SAMMPRIS trial who underwent MM and PTAS were included. Mean follow-up was 27.9 ± 17.0 months. The RO-ZES group demonstrated significantly fewer recurrent strokes (11.3%) compared with MM (27.0%) and PTAS (27.8%) (p = .003). The MM group experienced the lowest recurrence rate of ICH (0.9%) (p = .018). Multivariable regression revealed that RO-ZES experienced lower odds of recurrent strokes (OR = .40, 95% CI [0.17–0.92], p = .031) than PTAS throughout follow-up. Multivariable Cox regression demonstrated that RO-ZES stenting lowered the hazard of recurrent strokes compared with PTAS (hazard ratio = .36, 95% CI [0.16–0.80], p = .012).
Conclusion
Treatment of severe, symptomatic ICAD using RO-ZES was associated with lower odds of recurrent strokes compared with PTAS in this long-term follow-up study. Further prospective trials comparing MM with novel stent technologies are necessary.
Keywords
Drug-eluting stent, bare metal stent, intracranial atherosclerotic disease, stroke prevention
Published Open-Access
yes
Recommended Citation
Shoraka, Omid; Grandhi, Ramesh; Miller, Samantha; et al., "Long-Term Outcomes of Resolute Onyx Zotarolimus-Eluting Stents for Symptomatic Intracranial Stenosis: A Multicenter Propensity Score-Matched Comparison With Stenting Versus Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis Trial" (2025). Faculty and Staff Publications. 5344.
https://digitalcommons.library.tmc.edu/baylor_docs/5344