Abstract TP185: Resolute Onyx Stent for Symptomatic Intracranial Stenosis: Short and Long-Term Results (R.O.S.S.I.S. Study) With 18-month Follow-Up

Abstract

Introduction: The Resolute Onyx stent has shown promise as an effective treatment for symptomatic intracranial atherosclerotic disease (sICAD), with positive clinical outcomes and low procedural complication rates. However, previous studies were limited by small sample sizes and lacked long-term follow-up. Methods: In this retrospective analysis, we examined patients who underwent Resolute Onyx stent placement for sICAD. Primary outcomes included stroke, intracerebral hemorrhage (ICH), and mortality rates at 1-, 6-, 12-, and 18-month follow-ups, and in-stent restenosis. Multivariable logistic regression identified predictors of stroke and mortality. Subgroup analyses assessed patients who underwent stenting at least 8 days after the qualifying event to ensure comparability with WEAVE registry data. Results: Our study included 77 patients with 84 procedures. The mean age was 61.9±13.0, with 35% being female. The median time from qualifying event to procedure was 5 days (IQR: 2-11). Among adherent patients, no disease-related deaths occurred after the first month. However, one ICH and two strokes occurred within 6 and 12 months, respectively. Comparison of WEAVE-matched and non-matched patients revealed no significant difference in complications during short- and long-term follow-up. Postprocedural complications within 72 hours were <2% in the non-WEAVE group and 3% in the WEAVE group. Conclusions: The Resolute Onyx stent demonstrates safety and effectiveness in treating intracranial stenosis, with potentially lower rates of peri- and post-procedural complications compared to other stents. Our findings challenge the practice of delaying stent placement, emphasizing the importance of early intervention and questioning the validity of the WEAVE criteria.