Application of balloon-expandable stent angioplasty with dIstal support of the stent-retriever (BASIS-Stent) technique for acute intracranial artery atherosclerosis-related occlusion

Background Rescue stenting may be needed for intracranial atherosclerosis (ICAS)-related large vessel occlusion (LVO). Balloon-expandable (BE) stent implantation often fails due to its stiffness. Balloon-expandable stent angioplasty with the dIstal support of stent-retriever (BASIS-Stent) technique is a novel technique that increases the success and safety of BE stent implantation. Our study presents our initial experience with the BASIS-Stent technique for ICAS-related LVO that requires rescue stenting and to assess its feasibility. Method The clinical and angiographic data of acute ICAS-related LVO patients treated with the BASIS-Stent technique were retrospectively analyzed. The primary outcome was technical success, defined as successful BE stent implementation (successful deployment and satisfactory expansion). The secondary outcome was good prognosis at 90 days after the procedure, defined as a modified Rankin Scale (mRS) score of 0 to 2. The safety outcomes were procedural-related complications (ie, vessel perforation, dissection, vessel injury, distal embolism), postprocedural re-occlusion, and symptomatic intracranial hemorrhage (sICH). Results A total of 19 patients with acute ICAS-related LVO treated at two stroke centers were included, and the median age of the patients was 62 years. Drug-eluting BE stents were successfully implanted in all patients; expanded treatment in cerebral infarction (eTICI) 3 reperfusion was achieved in all patients, no patients experienced procedural-related occlusion, and one (1/19, 5.3%) experienced re-occlusion post-procedure due to in-stent thrombus. None of the patients had sICH. Good clinical outcomes were observed in 13 patients (68.4%), and no patients died. Conclusion BE stent implantation using the BASIS-Stent technique may be feasible and safe for treating acute ICAS-related LVO.