The resolute Onyx in TIA management (ROTIA)

Authors

Ameer E. Hassan, Valley Baptist Medical Center, University of Texas Rio Grande ValleyFollow
Ahmed M. Shoman, Valley Baptist Medical Center
Samantha Miller, Valley Baptist Medical CenterFollow
Abdulrahman Ibrahim Hagrass
Sohum Desai, The University of Texas Rio Grande Valley
Wondwossen Tekle, Valley Baptist Medical Center

Document Type

Article

Publication Date

4-2024

Abstract

Background

First-line treatment for symptomatic intracranial atherosclerotic disease (ICAD) is medical management; however, interventional approaches are increasingly considered for refractory disease. The Resolute Onyx in TIA management (ROTIA) study is a post-market evaluation of the Resolute Onyx (R-Onyx) drug-eluting stent in the treatment of recurrent transient ischemic attacks (TIAs) due to refractory ICAD (off-label use).

Methods

This is a single-center, retrospective case series of consecutive patients who underwent angioplasty and stenting with R-Onyx for treatment of recurrent TIAs due to refractory ICAD from October 2019 to November 2022. Included patients were ages 22–80, had a baseline modified Rankin Scale of ≤2, and had recurrent TIAs attributed to intracranial artery stenosis >70% despite maximal medical therapy. Primary outcomes of interest were peri-procedural complications (TIA, stroke, intracranial hemorrhage, mortality) up to 72 h post-stenting and ischemic stroke up to 18 months post-stenting.

Results

Twenty patients (mean age 66.84 ± 14; 25% female; 80% Hispanic) were included. A total of 21 stents were successfully deployed with no peri-procedural complications. There were no recurrent ischemic events at 30 days post-stenting. At 18 months post-stenting, there were no ischemic events and no patient exhibited in-stent restenosis.

Conclusion

ROTIA demonstrates the feasibility of using the Resolute Onyx drug-eluting stent for the management of TIAs due to refractory ICAD, with high technical success and low peri-procedural complications. Limitations include the retrospective and single-center nature of this study. Future prospective, multi-center, randomized trials with extended observation periods are needed.

Comments

© The Author(s) 2024

Recommended Citation

Hassan, A. E., Shoman, A. M., Miller, S., Hagrass, A. I., Desai, S., Saei, H., & Tekle, W. G. (2024). The resolute Onyx in TIA management (ROTIA). Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 15910199241249211. Advance online publication. https://doi.org/10.1177/15910199241249211

Publication Title

Interventional Neuroradiology

DOI

10.1177/15910199241249211

Academic Level

faculty

Mentor/PI Department

Neurology