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| Short and long term curative effects observation of intracranial stenting in the treatment of intracranial atherosclerotic stenosis and analysis on the risk factors of restenosis |
| WANG Jing1 XIE Yanzhao2 LIU Yun′e1 QIN Shijie1 ZHU Qian1 |
1.Ward One of Neurology Department, the First Hospital of Shijiazhuang, Hebei Province, Shijiazhuang 050011, China;
2.Department of Cardiology, Great Wall Integrated Chinese and Western Medicine of Shijiazhuang, Hebei Province, Shijiazhuang 050000, China |
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Abstract Objective To investigate the short and long term effect of intracranial stenting in the treatment of intracranial atherosclerotic stenosis and the risk factors of restenosis. Methods The clinical data of 78 patients with intracranial atherosclerotic stenosis and intracranial stent implantation admitted to the First Hospital of Shijiazhuang City from March 2013 to March 2015 were retrospectively analyzed. The incidence rate of postoperative restenosis was determined by imaging examination, and the incidence of postoperative end-point events was evaluated after 36 months of follow-up. According to the follow-up results, the patients were divided into restenosis group (21 cases) and non-restenosis group (57 cases), and the risk factors of postoperative restenosis were compared and analyzed. Results Among the 78 patients selected, the success rate of operdtion was 94.87%, preoperative and postoperative stenosis rates were significantly different (P < 0.05). Among the 78 patients selected, the restenosis rate was 26.92%, the results of univariate analysis showed that age > 55 years old, history of diabetes, history of hypertension, diameter of stent implantation ≥ 4.5 mm, hs-CRP > 3 mg/L were risk factors for in-rack restenosis (P < 0.05). Multivariate Logistic regression analysis showed that patients had a history of diabetes (OR = 3.87, 95%CI: 1.68-5.37, P = 0.043), a history of hypertension (OR = 1.81, 95%CI: 0.23-2.06, P = 0.037), stent diameter ≥ 4.5 mm (OR = 1.41, 95%CI: 0.61-2.48, P = 0.003), and hs-CRP > 3 mg/L (OR = 5.01, 95%CI: 1.26-8.04, P = 0.016) was an independent risk factor for restenosis after intracranial stent implantation. Conclusion The success rate of intracranial stenting in the treatment of intracranial atherosclerotic stenosis is high, and the recent curative effect is definite, but its long-term prognosis is not satisfactory. With a history of diabetes, hypertension, stent diameter ≥ 4.5 mm and hs-CRP ＞ 3 mg/L are independent risk factors for restenosis after intracranial stent implantation. Reasonable intervention against these risk factors can effectively control the risk of restenosis after intracranial stent implantation.
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