Abstract:Objective To investigate the effect of emergency stent implantation or balloon angioplasty on the outcome of patients with acute ischemic stroke related to intracranial atherosclerotic stenosis. Methods A total of 160 patients with acute ischemic stroke related to intracranial atherosclerotic stenosis who received emergency endovascular treatment in Nanjing Drum Tower Hospital Stroke Center or Nanjing Jiangbei Hospital from January 2019 to June 2022 were retrospectively included. The patients were divided into simple balloon angioplasty group (n=72) and stent implantation group (n=88) according to the angioplasty method. The demographic data, surgical related indicators, perioperative complications, the rate of vascular restenosis within 7 d and the outcome at 90 d after operation were compared between the two groups. Logistic regression was used to analyze the factors affecting the outcome of patients. Results After 90 days, 89 cases (55.6%) had good outcome (improved Rankin scale score≤2), and 13 cases (8.1%) died. Compared with the simple balloon dilation group, the stent implantation group had a higher 90-day good outcome rate［67.0% (59/88) vs 41.6% (30/72), χ²=19.711, P＜0.01］ and lower 90-day restenosis rate ［10.2% (9/88) vs 36.1% (26/72), P＜0.01］. There was no significant difference in the incidence of intracranial hemorrhage ［18.2% (16/88) vs 19.4% (14/72), χ²=0.041, P=0.839］ and mortality［8.0% (7/88) vs 8.3% (6/72), χ²=0.008, P=0.931］ between two groups. Multivariate logistic regression analysis showed that emergency stent placement was an independent protective factor for patients with good prognosis 90 d after surgery (OR=1.353, 95%CI: 1.089-3.485, P＜0.01). Conclusion Compared with balloon angioplasty, emergency stent implantation can improve the 90-day prognosis of patients with acute ischemic stroke related to intracranial atherosclerotic stenosis, reduce the rate of restenosis within 90 d, and do not increase the risk of perioperative bleeding.