{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T05:38:42Z","timestamp":1776836322589,"version":"3.51.2"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the optimal timing of endovascular treatment for acute cerebral infarction with symptomatic intracranial atherosclerotic stenosis (sICAS) in real world practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective single center study enrolled consecutive sICAS patients undergoing intervention. According to the interval from symptom onset to intervention, patients were divided into early (\u226414\u202fdays) and delayed (&amp;gt;14\u202fdays) intervention groups. Primary outcomes were any stroke or death within 30\u202fdays and the 90-day mRS score. Secondary analyses explored factors influencing surgical timing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 211 eligible patients, 174 were analyzed, including 53 patients in the early intervention group and 121 patients in the delayed intervention group. The 30-day stroke or death rates were 11.3 and 8.3%, and unfavorable 90-day outcomes were 18.9 and 10.7% in the early and delayed groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.521, 0.145). Higher preoperative NIHSS, higher albumin-to-globulin ratio, and higher LDL might be independent factors influencing the doctors\u2019 decision on the timing of the intervention (OR\u202f=\u202f0.819, 0.149, 0.394;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.027, 0.042, 0.004). Thresholds favoring early intervention were NIHSS\u202f\u2264\u202f3, albumin-to-globulin ratio\u202f&amp;lt;\u202f1.53, and LDL\u202f&amp;lt;\u202f2.85\u202fmmol\/L (AUC\u202f=\u202f0.664, 0.603, 0.642;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.001, 0.030, 0.003). For posterior circulation lesions, early intervention might led to more unfavorable outcomes than delayed intervention (29.2% vs. 8.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.033).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In anterior circulation sICAS with minor stroke (NIHSS\u202f\u2264\u202f3), high Alberta stroke program early CT score (ASPECTS)\/posterior circulation ASPECTS (pcASPECTS) (8\u20139), and well-controlled LDL, intervention timing may not be restricted, whereas Basilar artery (BA) lesions appear better suited for delayed intervention. Multiple parallel severe stenoses, severe pre-existing global brain injury, and plaque high-signal intensity did not influence on the surgical timing. The conclusions of this study should be validated in future prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1749046","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T04:40:38Z","timestamp":1776832838000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimal timing of endovascular treatment for symptomatic intracranial atherosclerotic stenosis: a real world single center study"],"prefix":"10.3389","volume":"17","author":[{"given":"Yang","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]},{"name":"Department of Neurology, Xi\u2019an Daxing Hospital","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoya","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jialiang","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ye","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lili","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yating","family":"Jian","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meijuan","family":"Dang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziwei","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fangcun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fan","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qingyu","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ning","family":"Bu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huqing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ru","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"An","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]},{"name":"Department of Neurology, Jiangxi Provincial People\u2019s Hospital (The First Affiliated Hospital of Nanchang Medical College)","place":["Nanchang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guilian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, 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