In-stent restenosis and stented-territory infarction after carotid and vertebrobasilar artery stentingopen access
- Authors
- Ryu, Jae-Chan; Bae, Jae-Han; Ha, Sang Hee; Kwon, Boseong; Song, Yunsun; Lee, Deok Hee; Chang, Jun Young; Kang, Dong-Wha; Kwon, Sun U.; Kim, Jong S.; Kim, Bum Joon
- Issue Date
- Feb-2023
- Publisher
- BMC
- Keywords
- In-stent restenosis; Ischemic stroke; Carotid stent; Vertebrobasilar stent
- Citation
- BMC NEUROLOGY, v.23, no.1
- Journal Title
- BMC NEUROLOGY
- Volume
- 23
- Number
- 1
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/87844
- DOI
- 10.1186/s12883-023-03110-z
- ISSN
- 1471-2377
- Abstract
- 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.
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