In-stent restenosis and stented-territory infarction after carotid and vertebrobasilar artery stenting

BMC Neurology

Research

Bum Joon Kim¹  Jae-Chan Ryu¹  Jae-Han Bae¹  Dong-Wha Kang¹  Jun Young Chang¹  Sun U. Kwon¹  Jong S. Kim²  Sang Hee Ha³  Deok Hee Lee⁴  Boseong Kwon⁴  Yunsun Song⁴ 

[1] Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea;Department of Neurology, Gil Medical Center, Gachon University, Incheon, Korea;Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;

关键词: In-stent restenosis;    Ischemic stroke;    Carotid stent;    Vertebrobasilar stent;   

DOI  :  10.1186/s12883-023-03110-z

 received in 2022-12-15, accepted in 2023-02-07,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPrognosis after vertebrobasilar stenting (VBS) may differ from that after carotid artery stenting (CAS). Here, we directly compared the incidence and predictors of in-stent restenosis and stented-territory infarction after VBS and compared them with those of CAS.MethodsWe enrolled patients who underwent VBS or CAS. Clinical variables and procedure-related factors were obtained. During the 3 years of follow-up, in-stent restenosis and infarction were investigated in each group. In-stent restenosis was defined as reduction in the lumen diameter > 50% compared with that after stenting. Factors associated with the occurrence of in-stent restenosis and stented-territory infarction in VBS and CAS were compared.ResultsAmong 417 stent insertions (93 VBS and 324 CAS), there was no statistical difference in in-stent restenosis between VBS and CAS (12.9% vs. 6.8%, P = 0.092). However, stented-territory infarction was more frequently observed in VBS than in CAS (22.6% vs. 10.8%; P = 0.006), especially a month after stent insertion. HbA1c level, clopidogrel resistance, and multiple stents in VBS and young age in CAS increased the risk of in-stent restenosis. Diabetes (3.82 [1.24–11.7]) and multiple stents (22.4 [2.4–206.4]) were associated with stented-territory infarction in VBS. However, in-stent restenosis (odds ratio: 15.1, 95% confidence interval: 3.17–72.2) was associated with stented-territory infarction in CAS.ConclusionsStented-territory infarction occurred more frequently in VBS, especially after the periprocedural period. In-stent restenosis was associated with stented-territory infarction after CAS, but not in VBS. The mechanism of stented-territory infarction after VBS may be different from that after CAS.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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