Durable fluoropolymer drug-eluting stent versus bare-metal stent for the prevention of intracranial in-stent restenosis

Although drug-eluting stents (DES) reduce the risk of in-stent restenosis (ISR) compared with bare-metal stents (BMS) in symptomatic intracranial atherosclerotic stenosis (ICAS), the reported 1-year ISR rate (9.5%) of current intracranial DES remains higher than that reported in coronary practice (2.5%–4.9%).

In this multicentre randomised trial of 156 patients with symptomatic ICAS, durable fluoropolymer DES significantly reduced the 1-year ISR rate to 2.9% versus 27.9% with BMS, achieving the lowest ISR rate reported in an intracranial DES randomised trial to date.

Durable fluoropolymer DES may be a promising device option for reducing ISR and providing a rationale for future randomised controlled trials comparing endovascular treatment with aggressive medical management in high-risk ICAS.