Evidence map›Paper›PMID 40717608›Full record

ReviewInterventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences2025

Next-generation Onyx DES for elective intracranial atherosclerosis: A meta-analysis.

Toka Adel Hassan, Ahar Bhatt, Fadar Oliver Otite, Steven Hoover, Danish Kherani, Maia Killory, Kaustubh Limaye, Tapan Mehta, Ameer E Hassan, Smit D Patel

Expression of concernAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It carries an expression of concern. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Toka Adel HassanDepartment of Medicine, October 6 University, Giza, Egypt.ORCID 0000-0001-6166-6955
Ahar BhattDepartment of Medicine, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India.ORCID 0009-0009-8462-899X
Fadar Oliver OtiteDepartment of Neurology, State University of New York Upstate Medical University, Syracuse, NY, USA.
Steven HooverDepartment of Interventional Neuroradiology, Saint Francis Health System, Tulsa, OK, USA.
Danish KheraniDepartment of Neurology, Saint Francis Health System, Tulsa, OK, USA.ORCID 0000-0003-4904-690X
Maia KilloryDepartment of Endovascular Surgical Neuroradiology, Hartford Hospital, Hartford, CT, USA.
Kaustubh LimayeDepartment of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA.ORCID 0000-0002-7280-7407
Tapan MehtaDepartment of Endovascular Surgical Neuroradiology, Hartford Hospital, Hartford, CT, USA.
Ameer E HassanDepartment of Endovascular Surgical Neuroradiology, University of Texas Rio Grande Valley, Edinburg, TX, USA.ORCID 0000-0002-7148-7616
Smit D PatelDepartment of Interventional Neuroradiology, Saint Francis Health System, Tulsa, OK, USA.ORCID 0000-0003-4369-7816

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BackgroundIntracranial atherosclerotic disease (ICAD) is a growing cause of ischemic stroke globally, with a disproportionately high burden in Asian, Black, and Hispanic populations. Despite advances in medical therapy, ICAD remains associated with high rates of recurrent stroke, prompting interest in durable endovascular solutions. This study aims to systematically evaluate the current evidence on the safety and efficacy of elective intracranial stenting in adult patients with symptomatic ICAD using Onyx drug-eluting balloon-mounted stents (Onyx DES).MethodsA meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five studies were initially identified, with one excluded due to overlapping cohorts, resulting in four final studies included for analysis. Meta-analysis was conducted utilizing random-effects models for pooled event rates (95% CIs) and weighted means.ResultsOf 153 articles initially identified, four high-quality studies encompassing 314 patients met inclusion criteria. The mean (±SD) age was 64.6 (±12.4) years, with a predominance of males (70.7%) and common vascular comorbidities such as hypertension (85.7%) and diabetes (60.0%). Lesions were nearly equally distributed between the anterior and posterior circulations. Periprocedural complications were infrequent (1.0%), including one hemorrhagic stroke and one fatal aneurysm rupture. The 30-day complication rate remained low at 5%, involving strokes, deaths, and TIAs. However, follow-up at six months and beyond revealed rising rates of strokes, TIAs, and in-stent restenosis, reaching 9% at six months and persisting through one year.ConclusionThis descriptive meta-analysis suggests that Onyx DES may offer promising results in the treatment of symptomatic ICAD, with lower early complication rates reported. However, larger prospective studies are needed to confirm these observations and evaluate long-term efficacy and safety.

Indexed as

in-stent restenosis (ISR)intracranial atherosclerotic diseaseOnyxresolute and Onyx frontier stentsstroke

Identifiers

PMID40717608
PMCPMC12303932

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.