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

Autor: Jae-Chan Ryu, Jae-Han Bae, Sang Hee Ha, Boseong Kwon, Yunsun Song, Deok Hee Lee, Jun Young Chang, Dong-Wha Kang, Sun U. Kwon, Jong S. Kim, Bum Joon Kim
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: BMC Neurology, Vol 23, Iss 1, Pp 1-9 (2023)
Druh dokumentu: article
ISSN: 1471-2377
DOI: 10.1186/s12883-023-03110-z
Popis: Abstract Background Prognosis 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. Methods We 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. Results Among 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. Conclusions Stented-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.
Databáze: Directory of Open Access Journals
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