Risk factors of in-stent restenosis of vertebral artery origin / 中华放射学杂志

ABSTRACT

Objective To evaluate risk factors of restenosis of vertebral artery origin after stenting.Methods A total of 144 continuous cases were collected for this retrospective analysis.More than 50％ of stenosis in the original sites after treatment was defined as restenosis.Patients were divided into restenosis group (39 patients) and none-restenosis group (105 patients).The risk factors associated with restenosis were compared between the two groups by Chi-square test,including sex,age,presence of hypertension,diabetes,coronary heart disease,hyperlipidemia,smoking and drinking,the difference of preoperative neurological symptoms,combination with other vessels,stenosis,as well as stent type and stent size.Logistic regression was used to test the risk factors for restenosis.Results The incidence of restenosis of vertebral artery origin after stenting was 26.4％,and all of them occurred in 5 months.Between the two groups,there was no significant difference of distribution of sex (male 89,female 34,x2 =0.804,P =0.370),age(60 vs 21 patients of more than 60 years old,x2 =2.358,P =0.125),hypertension (67 vs 28 patients,x2 =0.253,P =0.615),diabetes (27 vs 9 patients,x2 =0.914,P =0.91),hyperlipidemia (6 vs 5 patients,x2 =0.478,P =0.489),coronary heart disease(32 vs 6 patients,x2 =2.489,P =0.115),smoking (50 vs 24 patients,x2 =0.129,P =0.719),drinking(20 vs 13 patients,x2 =0.001,P =0.978),diameter of stents (53 vs 18 patients of more than 4 mm,x2 =0.213,P =0.645),length of stents (45 vs 19 patients of more than 15 mm,x2 =0.927,P =0.336),preoperative neurological symptoms (93 vs 29 patients,x2 =0.250,P =0.617).There was significant difference of factors including combination with the bilateral stenosis (43 vs 24 patients,x2 =4.844,P =0.028),combination with the internal carotid artery stenosis(49 vs 26 patients,x2 =4.558,P =0.033) and stent types(59 vs 11 patients of drug eluting stent,x2 =8.916,P =0.003) between the two groups.Bare stents and combination with internal carotid artery stenosis were independent risk factors for restenosis by logistic regression.Conclusions The incidence of restenosis with vertebral artery origin occurs in 5 months after surgery.Bare stents and combination with internal carotid artery stenosis increased the incidence of restenosis,and preoperative neurological symptoms of vertebrobasilar system and presence of the bilateral stenosis may induce restenosis.