Comparison of drug-coated balloon with bare-metal stent in patients with symptomatic intracranial atherosclerotic stenosis: the AcoArt sICAS randomized clinical trial.

Summary: When arteries in the brain narrow due to plaque buildup (a condition called sICAS), patients are at high risk for stroke. Doctors often treat this by inserting a metal mesh tube, known as a bare-metal stent, to prop the artery open. However, a major problem with these stents is that the artery often narrows again (restenosis) over time.

A new study tested a different approach: a "drug-coated balloon." Instead of leaving a metal scaffold behind, doctors inflate a balloon coated with medication inside the artery to open it and treat the vessel wall, then remove it entirely. The results were striking. Patients treated with the drug-coated balloon had a significantly lower rate of re-narrowing (only 6.9%) compared to those with standard metal stents (32.9%). Importantly, the balloon method was just as safe as stenting, offering a promising new way to prevent recurrent strokes without leaving permanent metal in the brain.