Abstract Number: Esoc2026a1933 Evolution of Revascularization Treatment in Intracranial Artery Stenosis

Abstract Background and aims Cervico-cerebral vessel stenosis are a significant cardiovascular risk factor linked to ischemic strokes. This study analyzed 4,227 patients over three years (51.45% women, 48.55% men, mean age 69), with 1,217 exhibiting hemodynamically significant stenoses (28% extracranial, 8.9% intracranial, 4.5% both). Among these, 63 experienced acute ischemic events and underwent revascularization, mainly via intravenous thrombolysis. The goal was to evaluate patients' clinical outcomes post-revascularization. Methods All patients had a modified Rankin Scale (mRS) score between 0 and 1 prior to intervention. The primary aim was to achieve an mRS of 0–2 at discharge, with scores ≥3 indicating suboptimal benefit. Clinical evolution was monitored during hospitalization (average 7–10 days), but long-term follow-up was limited due to variable neurorehabilitation protocols. Results Despite only 5% of patients with significant carotid and vertebral atherosclerosis benefiting from revascularization, intracranial stenosis patients showed the best outcomes, with up to 88% experiencing favorable recovery. Those with solely extracranial stenosis had worse outcomes than intracranial cases, with over 42% improving. Conversely, patients with combined extracranial and intracranial stenosis, including tandem cases, had even poorer results (~30% favorable). Conclusions Although the study cohort was small, data suggest that patients with intracranial stenoses are the most suitable candidates for revascularization therapy, as they had the better outcome. But, the ratio of patients with extracranial stenosis to those with intracranial stenosis was approximately 3:1. These findings underscore the importance of early detection and treatment of atherosclerotic modifications of cervico-cerebral vessels, during routine check-ups, to prevent ischemic events and improve clinical outcomes. Conflict of interest Teodor Trinca: nothing to disclose