Abstract

Background: Intracranial atherosclerotic stenosis (ICAS) is a major global cause of stroke. Patient with high risk of recurring strokes despite standard medication therapy usually needs aggressive medical treatment such as self-expanding and balloon-expandable stents. Drug-eluting stents (DESs), with anti-vascular endothelial cell proliferation drugs, aim to inhibit smooth muscle cells proliferation and migration, providing a promising alternative to standard bare metal stents (BMS). This study compared the advantages and safety of DES to BMS in symptomatic ICAS patients. Methods: A comprehensive search was conducted through PubMed, Cochrane Central Register of Controlled Trials, and Science Direct in May 2024, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized trials comparing DES and BMS for symptomatic intracranial and vertebral artery stenosis were included in the study. Meta-analysis was carried out by RevMan software to analyze and odds ratio (OR) for primary and secondary outcomes. Results: = 0.02). Conclusion: Intravascular DES is more effective than BMS in lowering risk of ISR and incidence of ischemic stroke in symptomatic ICAS.

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