Factors Influencing the Outcome of Symptomatic Intracranial Artery Stenosis With Hemodynamic Impairment After Short and Long-Term Stent Placement

Gong, Wentao; Zhang, Xianjun; Meng, Zhen; Liu, Feifei; Li, Guangwen; Xiao, Juan; Liu, Peng; Sun, Yujie; Liu, Tonghui; Wang, Hongxia; Zhang, Yong; Wang, Naidong

doi:10.3389/fneur.2022.682694

Cited by 2 publications

(1 citation statement)

References 49 publications

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“…A high restenosis rate is a frustrating outcome of PTAS ( 14 ). In a post-hoc SAMMPRIS analysis, 66.7% of cases with an ischemic event beyond 30 days were attributed to restenosis of the offending vessel during the follow-up.…”

Section: Discussionmentioning

confidence: 99%

Has collateral blood flow any effect on restenosis rate? Our experience

Li,

Sun,

Liu

et al. 2024

Front. Neurol.

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ObjectivesRestenosis is one of the important factors affecting the effectiveness of percutaneous transluminal angioplasty and stenting in the treatment of intracranial atherosclerotic stenosis. We aimed to clarify whether recruitable collateral flow could cause restenosis in patients treated with percutaneous transluminal angioplasty and stenting.Material and methodsOur study retrospectively analyzed patients with symptomatic severe intracranial atherosclerotic stenosis (≥70%) who underwent percutaneous transluminal angioplasty and stenting. We enrolled 28 patients with restenosis and 71 patients without restenosis. We analyzed baseline data, perioperative events, and follow-up results of patients in the two groups. Binary logistic regression analysis was used to identify restenosis predictors.ResultsFor preoperative stroke, the restenosis group had a greater likelihood of having a previous stroke (89.3%), which was less prevalent in the non-restenosis group (66.2%) (P = 0.020). The restenosis group had a higher rate of re-stroke (21.4 vs. 4.2%, P = 0.022). After binary logistic regression analysis, collateral circulation and residual stenosis were independent risk factors of restenosis, with overall risk (95% confidence intervals) of 5.034 (1.484–4.066, P < 0.001) and 1.064 (1.006–1.125, P = 0.030), respectively. Restenosis risk increased 1.456-fold for each collateral circulation grade increase. However, for each 1% increase in residual stenosis, restenosis risk increased by 5.9% (P = 0.03). The chance of restenosis is minimal when the residual stenosis rate after percutaneous transluminal angioplasty and stent implantation is 15.85%.ConclusionsGood collateral circulation was significantly associated with restenosis in patients undergoing intracranial angioplasty, the residual stenosis rate tends to be 15.85% to reduce restenosis risk. Compared to patients with restenosis, those without restenosis have a low stroke risk during follow-up.

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Section: Discussionmentioning

confidence: 99%

Has collateral blood flow any effect on restenosis rate? Our experience

Li,

Sun,

Liu

et al. 2024

Front. Neurol.

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Endovascular Recanalization for Nonacute Carotid Artery Occlusion: A Nationwide Registry‐Based Cohort Study

Hou,

Shi,

Huo

et al. 2024

SVIN

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BACKGROUND The management of nonacute symptomatic internal carotid artery occlusion remains unsatisfactory. Endovascular recanalization has been reported to be feasible but associated with a noteworthy risk of postprocedural complications in patients with symptomatic internal carotid artery occlusion. The present study aimed to investigate whether successful recanalization exerts clinical benefits over procedural risks. METHODS We analyzed consecutive patients who underwent endovascular treatment of nonacute symptomatic internal carotid artery occlusion in a nationwide prospective registry. The primary outcome was the ipsilateral ischemic stroke recurrence. Other outcomes of interest included all strokes and death during follow‐up, and 30‐day symptomatic intracranial hemorrhage, and all strokes after intervention. RESULTS The final analysis included 511 patients. Endovascular revascularization was successful in 300 patients (58.7%) but failed in 211 patients (41.3%). Patients with successful recanalization had less time from the last ischemic event to the endovascular treatment as compared with patients with failed recanalization (median [interquartile range] days, 18 [12–33] versus 22 [14–50]; P =0.003). Successful recanalization was associated with a higher rate of symptomatic intracranial hemorrhage within 30 days after intervention (odds ratio [OR], 7.99 [95% CI, 1.02–62.39]; P =0.047). Thirty‐day all strokes (OR, 1.91 [95% CI, 0.83–4.40]; P =0.128) and ischemic stroke (OR, 0.90 [95% CI, 0.33–2.46]; P =0.839) did not differ significantly. During a median follow‐up of 37 months, patients with successful recanalization demonstrated a reduced risk of ipsilateral ischemic stroke (adjusted hazard ratio, 0.28 [95% CI, 0.13–0.59]; P <0.001). The 5‐year risk of all strokes and death was likewise lower in patients with successful recanalization (restricted mean survival time difference, 3.77 months [95% CI, 0.16–7.38]; P =0.041). CONCLUSION Despite an increase in the 30‐day symptomatic intracranial hemorrhage, successful recanalization was associated with reduced long‐term risk of ipsilateral ischemic stroke in patients with symptomatic internal carotid artery occlusion.

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Factors Influencing the Outcome of Symptomatic Intracranial Artery Stenosis With Hemodynamic Impairment After Short and Long-Term Stent Placement

Cited by 2 publications

References 49 publications

Has collateral blood flow any effect on restenosis rate? Our experience

Has collateral blood flow any effect on restenosis rate? Our experience

Endovascular Recanalization for Nonacute Carotid Artery Occlusion: A Nationwide Registry‐Based Cohort Study

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