To observe the safety and effectiveness of drug-eluting stent (DES) in the treatment of acute middle cerebral artery occlusive stroke.

Retrospective analysis on December 5, 2021 to March 1, 2023 in the XD Group Hospital, Xianyang First People's Hospital, Xi'an Central Hospital, Xijing Hospital, Shaanxi Provincial People's Hospital, Xi'an Northern Hospital, and Xi'an DaXing Hospital seven Hospitals acute middle cerebral artery stroke caused by atherosclerotic occlusion underwent emergency treatment of the clinical data of 34 patients with intracranial DES, Clinical baseline characteristics imaging characteristics (CT-Aspects, DWI-Aspects, CTP) were observed. Surgical situation (DPT, TICI, sICH, NIHSS score immediately after surgery, NIHSS score 24 hours after surgery, NIHSS score 30d after surgery, and mRS score 30 d after surgery), clinical prognosis (mRS score 90 d after surgery, stroke recurrence rate and death rate within 90d after surgery) and incidence of in-stent restenosis 90 days after surgery. Differences in the baseline NIHSS, the mRS score, and the postoperative 30 d NIHSS and the mRS score were compared by t-test.

The average age of the 34 patients was (64.6±6.5) years old, including 24 males (70.6%), 27 patients with hypertension (79.4%), 17 patients with diabetes (50.0%), 12 patients with hyperlipidemia (35.3%), 12 patients with high homocysteine (35.3%), 0 patients with atrial fibrillation, and 20 patients with smokers (58.8%). The mean onset time was (8.9±4.6) hours, the baseline NIHSS score was 7.9±1.1, and the baseline mRS score was 2.7±1.1. CT-ASPECTS score was 9.8±0.4, DWI-ASPECTS score was 8.0±1.0. There were 22 cases (64.7%) of right middle cerebral artery occlusion and 12 cases (35.3%) of left middle cerebral artery occlusion. The mean CTP mismatched volume was (96.5±30.1) ml. 34 patients reached mTICI grade 3 immediately after surgery, and the successful replantation rate was 100%. After operation, one patient had asymptomatic intracranial hemorrhage, and the incidence of sICH was 0%. The NIHSS score at 30 days after operation was 3.6±2.3, which was lower than baseline, and the difference was statistically significant (t=3.975, P=0.001). The mRS score at 30 d after operation was 1.6±0.8, lower than baseline, and the difference was statistically significant (t=2.24, P=0.038). 90-day postoperative follow-up showed that 85.7% (29/34) of the patients had a good clinical prognosis (mRS score 0-2), no patients died, no patients with recurrent ischemic stroke, and no intrastent restenosis occurred.

DES treatment is safe and effective in patients with acute mid-cerebral atherosclerotic occlusive stroke, and the restenosis rate is low in short-term follow-up.