Abstract

Background: Intracranial atherosclerotic stenosis (ICAS) is a major cause of ischemic stroke, posing challenges due to its progressive nature and high recurrence risk. Endovascular interventions like balloon angioplasty show promise in improving blood flow and stabilizing stenotic arteries, particularly in symptomatic ICAS (sICAS) patients unresponsive to medical therapy. This study evaluates outcomes of balloon angioplasty for sICAS at Pelni Hospital over 3.5 years. Methods: A retrospective cohort study of 31 sICAS patients undergoing balloon angioplasty (January 2021–July 2024) assessed demographics, lesion locations, procedural success, and outcomes. Standard endovascular techniques under fluoroscopic guidance were used, focusing on procedural success, complications, and patient stability. Results: Balloon angioplasty was successful in all patients (100%). Most lesions were in the posterior circulation, particularly the vertebrobasilar artery (54.8%), with anterior circulation lesions in the internal carotid (25.8%) and middle cerebral arteries (19.4%). Complications occurred in 2 patients (6.5%), both resulting in adverse outcomes, including death. The remaining 29 patients (93.5%) experienced no significant complications and remained stable during follow-up. Conclusions: Balloon angioplasty demonstrates high success with low complication rates for sICAS, offering a viable therapeutic option for severe stenosis unresponsive to medical therapy. Further research is needed to confirm long-term efficacy, refine patient selection, and enhance clinical outcomes. Keywords: Balloon Angioplasty, Endovascular Treatment, Intracranial Atherosclerotic Stenosis

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