Abstract 009: 1‐Year Outcomes of Resolute Onyx Zotarolimus‐Eluting Stent for Intracranial Atherosclerotic Disease: Multicenter Comparison with SAMMPRIS

Abstract

Introduction Intracranial atherosclerotic disease (ICAD) is one of the most prevalent causes of stroke across the world, with a high morbidity and mortality rate. Endovascular treatment (ET) has gained prominence but remains a challenge with unfavorable results. Recent literature has demonstrated that the Resolute Onyx Zotarolimus‐Eluting stent (RO‐ZES) is a technically safe option with low complication rates. Preliminary data has also reported the 30‐day outcomes associated with intracranial stent placement for ICAD with RO‐ZES compared to results from the Stenting Versus Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial. Here, we aim to compare outcomes at 1 year with the SAMMPRIS trial to further evaluate the efficacy and outcomes of RO‐ZES in a multicenter study with long‐term follow up extending beyond 30 days. Methods Prospectively maintained databases across 7 stroke centers were reviewed to identify adult patients undergoing RO‐ZES placement for treatment of ICAD between January 2019 to May 2023. The primary endpoint was composite of 1‐year stroke, ICH, and/or death. This data was propensity score matched using age, sex, hypertension, diabetes mellitus, smoking status, and impacted vessel for comparison between RO‐ZES and the SAMMPRIS percutaneous angioplasty and stenting groups (S‐PTAS). Results A total of 104 patients met the inclusion criteria for analysis (mean age 62.6, 31.7% female). Impacted vessels included basilar artery (6.7%), internal carotid artery (26.9%), middle cerebral artery (29.8%), posterior cerebral artery (1.0%), and vertebral artery (35.6%). Propensity score match analysis of the 104 patients with S‐PTAS demonstrated 1‐year stroke, ICH, and/or death rate of 11.5% in the RO‐ZES group and 35.6% in the S‐PTAS group (OR 4.17, 95% CI 2.06‐8.96, p=0.001). Conclusion The RO‐ZES system provides a not only safe and effective alternative to other traditional stents, but also demonstrates strong potential to reduce long‐term complications at 1 year compared with the S‐PTAS group. Further prospective multicenter studies are needed to corroborate the findings and compare RO‐ZES directly with other stents.