{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T13:39:47Z","timestamp":1782135587458,"version":"3.54.5"},"reference-count":29,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,28]],"date-time":"2024-12-28T00:00:00Z","timestamp":1735344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Intracranial atherosclerosis (ICAS) is a major cause of ischemic stroke, disproportionately affecting populations with significant vascular risk factors. Although ICAS imposes a considerable health burden, research on this condition in Central Asia remains scarce, especially among the Kazakh population. This study analyzes demographic characteristics, treatment outcomes, and procedural challenges associated with ICAS in 216 patients treated at a single institution. Methods: This retrospective study included patients with \u226570% intracranial artery stenosis confirmed by imaging and presenting with ischemic symptoms. All patients underwent angioplasty and stenting with dual antiplatelet therapy (DAPT). Data collected included demographics, comorbidities, stenosis characteristics, procedural details, and outcomes assessed by the modified Rankin Scale (mRS). Results: The median age was 63.5 years (IQR: 57\u201368.6), and 73.7% were male. Hypertension was the most common comorbidity (98%), followed by ischemic heart disease (58%) and diabetes mellitus (40.9%). Multi-location ICAS was significantly associated with patients over 75 years of age (p = 0.025). Additionally, obesity and stenosis severity greater than 70% showed trends toward significance, with p-values of 0.064 and 0.079, respectively. Stenosis predominantly affected the internal carotid artery (54.5%) and vertebrobasilar system (31.6%). The average hospital stay was longer for posterior circulation stenosis (7.1 days) compared to anterior circulation (4.7 days). The periprocedural complication rate was 0.7%, with two deaths attributed to ischemic complications. At follow-up, four patients experienced worsening mRS scores (&gt;2), particularly those with severe stenosis in the basilar artery and M1 segment. Conclusions: ICAS in the Kazakh population is strongly associated with hypertension and aging, with posterior circulation stenosis contributing disproportionately to worse outcomes. The low complication rates highlight the safety of modern endovascular techniques. However, further research is needed to optimize treatment strategies for severe and multi-location ICAS, particularly in Central Asian populations.<\/jats:p>","DOI":"10.3390\/jcm14010125","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T07:00:37Z","timestamp":1735628437000},"page":"125","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Demographic Characteristics and Treatment Outcomes of Intracranial Atherosclerosis Stenting: A Retrospective Case-Series of 216 Consecutive Patients"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1757-9189","authenticated-orcid":false,"given":"Marat","family":"Sarshayev","sequence":"first","affiliation":[{"name":"\u201cJoint-Stock Company\u201d Central Clinical Hospital, Almaty 050060, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Botagoz","family":"Turdaliyeva","sequence":"additional","affiliation":[{"name":"Kazakhstan School of Public Health, Kazakhstan\u2019s Medical University, Almaty 050060, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulnur","family":"Tanbayeva","sequence":"additional","affiliation":[{"name":"Department of Public Health, Al-Farabi Kazakh National University, Almaty 050060, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2606-4785","authenticated-orcid":false,"given":"Shayakhmet","family":"Makhanbetkhan","sequence":"additional","affiliation":[{"name":"\u201cJoint-Stock Company\u201d Central Clinical Hospital, Almaty 050060, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxat","family":"Mussabekov","sequence":"additional","affiliation":[{"name":"\u201cJoint-Stock Company\u201d Central Clinical Hospital, Almaty 050060, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6100-4963","authenticated-orcid":false,"given":"Dimash","family":"Davletov","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Asfendiyarov Kazakh National Medical University, Almaty 050060, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3321-9714","authenticated-orcid":false,"given":"Aiman","family":"Maidan","sequence":"additional","affiliation":[{"name":"National Centre for Neurosurgery, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1260-5923","authenticated-orcid":false,"given":"Mynzhylky","family":"Berdikhojayev","sequence":"additional","affiliation":[{"name":"\u201cJoint-Stock Company\u201d Central Clinical Hospital, Almaty 050060, Kazakhstan"},{"name":"Hospital of the Medical Center of the Administration of the President of the Republic of Kazakhstan, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/S1474-4422(24)00369-7","article-title":"Global, Regional, and National Burden of Stroke and Its Risk Factors, 1990\u20132021: A Systematic Analysis for the Global Burden of Disease Study 2021","volume":"23","author":"Feigin","year":"2024","journal-title":"Lancet Neurol."},{"key":"ref_2","first-page":"1033","article-title":"Stroke-Free Survival and Its Determinants in Patients with Symptomatic Vertebrobasilar Stenosis: A Multicenter Study","volume":"52","author":"Qureshi","year":"2003","journal-title":"Neurosurgery"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/0021-9681(67)90066-5","article-title":"The Geographic Pathology of Atherosclerosis: A Review of the Literature with Some Personal Observations on Cerebral Atherosclerosis","volume":"20","author":"Baker","year":"1967","journal-title":"J. Chronic Dis."},{"key":"ref_4","unstructured":"Pahwa, R., and Jialal, I. (2024). Atherosclerosis. StatPearls, StatPearls Publishing."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1698","DOI":"10.1016\/j.mayocp.2024.05.023","article-title":"Establishment of an Atherosclerosis and Dyslipidemia Program in Kazakhstan","volume":"99","author":"Bekbossynova","year":"2024","journal-title":"Mayo Clin. Proc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1136\/svn-2018-000158","article-title":"Stenting for Intracranial Stenosis: Potential Future for the Prevention of Disabling or Fatal Stroke","volume":"3","author":"Yu","year":"2018","journal-title":"Stroke Vasc. Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1159\/000448313","article-title":"Non-Atherosclerotic Intracranial Arterial Diseases","volume":"Volume 40","author":"Kim","year":"2016","journal-title":"Frontiers of Neurology and Neuroscience"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Del Brutto, V.J., Ortiz, J.G., and Biller, J. (2017). Intracranial Arterial Dolichoectasia. Front. Neurol., 8.","DOI":"10.3389\/fneur.2017.00344"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.ejvs.2022.04.011","article-title":"Editor\u2019s Choice\u2014European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on the Management of Atherosclerotic Carotid and Vertebral Artery Disease","volume":"65","author":"Naylor","year":"2023","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e18435","DOI":"10.1016\/j.heliyon.2023.e18435","article-title":"Improving Multidisciplinary Hospital Care for Acute Cerebral Circulation Disorders in Kazakhstan","volume":"9","author":"Adenova","year":"2023","journal-title":"Heliyon"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1001\/jama.2022.12000","article-title":"Effect of Stenting Plus Medical Therapy vs Medical Therapy Alone on Risk of Stroke and Death in Patients with Symptomatic Intracranial Stenosis: The CASSISS Randomized Clinical Trial","volume":"328","author":"Gao","year":"2022","journal-title":"JAMA"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1002\/ana.21768","article-title":"Intracranial Atherosclerotic Disease: An Update","volume":"66","author":"Qureshi","year":"2009","journal-title":"Ann. Neurol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1016\/S1474-4422(13)70195-9","article-title":"Atherosclerotic Intracranial Arterial Stenosis: Risk Factors, Diagnosis, and Treatment","volume":"12","author":"Holmstedt","year":"2013","journal-title":"Lancet Neurol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1161\/01.STR.26.1.14","article-title":"Race-Ethnicity and Determinants of Intracranial Atherosclerotic Cerebral Infarction. The Northern Manhattan Stroke Study","volume":"26","author":"Sacco","year":"1995","journal-title":"Stroke"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"S20","DOI":"10.1161\/STROKEAHA.110.597278","article-title":"Intracranial Atherosclerosis: Current Concepts","volume":"42","author":"Arenillas","year":"2011","journal-title":"Stroke"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"107605","DOI":"10.1016\/j.jdiacomp.2020.107605","article-title":"Hyperglycemia, Duration of Diabetes, and Intracranial Atherosclerotic Stenosis by Magnetic Resonance Angiography: The ARIC-NCS Study","volume":"34","author":"Fujiyoshi","year":"2020","journal-title":"J. Diabetes Complicat."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1161\/STROKEAHA.107.496513","article-title":"Autopsy Prevalence of Intracranial Atherosclerosis in Patients with Fatal Stroke","volume":"39","author":"Mazighi","year":"2008","journal-title":"Stroke"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1056\/NEJMoa1105335","article-title":"Stenting versus Aggressive Medical Therapy for Intracranial Arterial Stenosis","volume":"365","author":"Chimowitz","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2011","DOI":"10.1161\/01.STR.31.8.2011","article-title":"Posterior Circulation Ischemia: Then, Now, and Tomorrow: The Thomas Willis Lecture\u20142000","volume":"31","author":"Caplan","year":"2000","journal-title":"Stroke"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"720","DOI":"10.5551\/jat.43240","article-title":"Clinical and Imaging Characteristics of Cerebral Infarction in Patients with Nonvalvular Atrial Fibrillation Combined with Cerebral Artery Stenosis","volume":"25","author":"Sun","year":"2018","journal-title":"J. Atheroscler. Thromb."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1971","DOI":"10.1161\/STROKEAHA.110.595926","article-title":"Outcome of Patients with \u226570% Symptomatic Intracranial Stenosis after Wingspan Stenting","volume":"42","author":"Jiang","year":"2011","journal-title":"Stroke"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1212\/WNL.39.9.1246","article-title":"Intracranial Branch Atheromatous Disease: A Neglected, Understudied, and Underused Concept","volume":"39","author":"Caplan","year":"1989","journal-title":"Neurology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2","DOI":"10.5469\/neuroint.2021.00087","article-title":"Intracranial Stenting; the Current Landscape","volume":"16","author":"Kim","year":"2021","journal-title":"Neurointervention"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1161\/STROKEAHA.113.003508","article-title":"Prevalence and Outcomes of Symptomatic Intracranial Large Artery Stenoses and Occlusions in China: The Chinese Intracranial Atherosclerosis (CICAS) Study","volume":"45","author":"Wang","year":"2014","journal-title":"Stroke"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1161\/STROKEAHA.118.023996","article-title":"WEAVE Trial: Final Results in 152 On-Label Patients","volume":"50","author":"Alexander","year":"2019","journal-title":"Stroke"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1136\/neurintsurg-2020-016208","article-title":"The WOVEN Trial: Wingspan One-Year Vascular Events and Neurologic Outcomes","volume":"13","author":"Alexander","year":"2021","journal-title":"J. Neurointerv. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3","DOI":"10.5853\/jos.2021.01375","article-title":"Endovascular Treatment of Large Vessel Occlusion Strokes Due to Intracranial Atherosclerotic Disease","volume":"24","author":"Lee","year":"2022","journal-title":"J. Stroke"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2396","DOI":"10.1161\/STROKEAHA.107.505776","article-title":"Large Artery Intracranial Occlusive Disease: A Large Worldwide Burden but a Relatively Neglected Frontier","volume":"39","author":"Gorelick","year":"2008","journal-title":"Stroke"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1002\/ana.10644","article-title":"Frequency and Mechanisms of Stroke Recurrence after Cryptogenic Stroke","volume":"54","author":"Bang","year":"2003","journal-title":"Ann. Neurol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/1\/125\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:55:40Z","timestamp":1760115340000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/1\/125"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,28]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["jcm14010125"],"URL":"https:\/\/doi.org\/10.3390\/jcm14010125","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,28]]}}}