Timing Considerations for Endovascular Intervention in Patients with Symptomatic Intracranial Atherosclerotic Stenosis: Insights from a Single-Center Real-World Analysis

Category	Detail
Condition	Symptomatic Intracranial Atherosclerotic Stenosis (sICAS)
Key Mechanisms	Endovascular treatment including stenting and balloon angioplasty for acute cerebral infarction.
Target Population	Patients with symptomatic intracranial atherosclerotic stenosis undergoing intervention.
Care Setting	Single-center retrospective study.

Early intervention (≤14 days) showed no significant difference in 30-day stroke or death rates compared to delayed intervention (>14 days).
Higher preoperative NIHSS, albumin-to-globulin ratio, and LDL levels influenced timing decisions.
Thresholds favoring early intervention included NIHSS ≤ 3, albumin-to-globulin ratio < 1.53, and LDL < 2.85 mmol/L.
Posterior circulation lesions may have worse outcomes with early intervention.
The 2022 China expert consensus recommends delayed intervention (>14 days) for most cases.

Consider endovascular treatment more than 14 days after ischemic event, except in progressive stroke cases.

Monitor for stroke recurrence, particularly within the first 14 days post-event.

Increased risk of complications with early intervention, especially in posterior circulation lesions.

Patients with symptomatic intracranial atherosclerotic stenosis undergoing endovascular intervention.

Early intervention may not be beneficial for posterior circulation lesions; careful assessment of NIHSS and LDL is crucial.

Assess NIHSS, albumin-to-globulin ratio, and LDL levels when determining intervention timing.
Prioritize delayed intervention for basilar artery lesions.

Clinical Scorecard: Timing Considerations for Endovascular Intervention in Patients with Symptomatic Intracranial Atherosclerotic Stenosis: Insights from a Single-Center Real-World Analysis