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In-stent restenosis and stented-territory infarction after carotid and vertebrobasilar artery stenting.
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.
  • Ryu JC; Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • Bae JH; Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • Ha SH; Department of Neurology, Gil Medical Center, Gachon University, Incheon, Korea.
  • Kwon B; Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • Song Y; Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • Lee DH; Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • Chang JY; Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • Kang DW; Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • Kwon SU; Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • Kim JS; Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
  • Kim BJ; Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. medicj80@hanmail.net.
BMC Neurol ; 23(1): 79, 2023 Feb 21.
Article in English | MEDLINE | ID: covidwho-2302861
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Carotid Stenosis / Coronary Restenosis Type of study: Cohort study / Observational study / Prognostic study Limits: Humans Language: English Journal: BMC Neurol Journal subject: Neurology Year: 2023 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Carotid Stenosis / Coronary Restenosis Type of study: Cohort study / Observational study / Prognostic study Limits: Humans Language: English Journal: BMC Neurol Journal subject: Neurology Year: 2023 Document Type: Article