{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T18:11:07Z","timestamp":1788891067808,"version":"build-2803163510"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["SVIN"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Symptomatic intracranial atherosclerotic disease can be managed with medical therapy, risk factor control, angioplasty, and stenting. The Wingspan stent demonstrated limited efficacy and higher adverse outcomes than medical management in the SAMMPRIS trial (Stenting Versus Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis). Drug-eluting stents, including the Resolute Onyx Zotarolimus-eluting stent, have demonstrated superior outcomes beyond 1 year. This study assessed outcomes at \u226524 months after stenting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>This retrospective multicenter study compared patients diagnosed with severe symptomatic intracranial atherosclerotic disease who underwent Resolute Onyx Zotarolimus-eluting stent stenting between March 2018 and May 2021 with patients from the percutaneous angioplasty and stenting and the aggressive medical management arms of the SAMMPRIS trial. Individuals who remained alive, stroke-free, and under follow-up at 24 months were included. Propensity score matching was used to align the 3 arms, and landmark analysis using inverse probability weighting, accounting for differential survival to 24 months, was used as complementary sensitivity analysis. The primary outcomes measured were postlandmark (ie, 24 months) stroke recurrence, intracranial hemorrhage, and all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      After applying the 24-month landmark and propensity score matching, 204 patients (68 per arm) were eligible (median follow-up, 36 months). Unweighted rates of stroke (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.147), intracranial hemorrhage (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.362), and mortality (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.168) did not differ significantly among groups. Weighted multivariable logistic and Cox regression analyses, adjusting for residual postmatch differences, similarly showed no significant differences in stroke recurrence. Kaplan-Meier analysis did not demonstrate a significant difference in overall survival across the 3 arms (log-rank\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.139).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Although previous studies have demonstrated the superiority of the Resolute Onyx Zotarolimus-eluting stent compared with the Wingspan system and aggressive medical management for the treatment of severe symptomatic intracranial atherosclerotic disease, the present landmark analysis suggests that these benefits may not consistently extend beyond 24 months. One speculative explanation is that the drug elution\u2013related benefit of the Resolute Onyx Zotarolimus-eluting stent may attenuate over time, but this was not directly assessed in the present study. Prospective, controlled trials are necessary to confirm the implications of our long-term findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/svin.125.002204","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T09:00:14Z","timestamp":1783587614000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Durability of Drug-Eluting Balloon-Mounted Stents in Symptomatic ICAD: A Propensity-Matched Landmark Analysis of RO-ZES Versus Wingspan or Medical Management Beyond 24 Months"],"prefix":"10.1161","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1387-3866","authenticated-orcid":true,"given":"Omid","family":"Shoraka","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, The University of Utah, Salt Lake City (O.S., O.H., R.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oz","family":"Haim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, The University of Utah, Salt Lake City (O.S., O.H., R.G.)."},{"name":"Department of Neurosurgery, Tel-Aviv University, Israel (O.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9851-8622","authenticated-orcid":true,"given":"Samantha","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Neurology, Valley Baptist-University of Texas Rio Grande Valley, Harlingen (S.M., A.E.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4829-1869","authenticated-orcid":true,"given":"Joanna M.","family":"Roy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA (J.M.R., B.M., P.M.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6677-1858","authenticated-orcid":true,"given":"Vinay","family":"Jaikumar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Buffalo, NY (V.J., A.H.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4910-6090","authenticated-orcid":true,"given":"Basel","family":"Musmar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA (J.M.R., B.M., P.M.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Tanweer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Baylor College of Medicine, Houston, TX (O.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8381-0313","authenticated-orcid":true,"given":"Jan-Karl","family":"Burkhardt","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia (J.-K.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8965-2413","authenticated-orcid":true,"given":"Pascal M.","family":"Jabbour","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA (J.M.R., B.M., P.M.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9519-0059","authenticated-orcid":true,"given":"Adnan H.","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Buffalo, NY (V.J., 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