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Intracranial in-stent restenosis increased risk for ischemic event
Intracranial in-stent restenosis was significantly and independently associated with a higher risk for recurrent ischemic events in the territory of the stented intracranial artery, according to study results.
Patients with intracranial in-stent restenosis (ISR) compared with those without intracranial ISR were also found to be at higher risk for earlier occurrence of the ischemic events.
Researchers of the study, published in Stroke, enrolled 226 patients with 233 stented arteries. Most of the patients were men (n=189). All patients enrolled in the study had catheter angiography follow-up with a mean follow-up time after stenting of 10.1 months. The researchers classified 57 (24.5%) of the 233 total lesions into the intracranial ISR group, and 176 lesions into the non-ISR group. The researchers then looked at the primary endpoint of ischemic stroke or transient ischemic attack in the territory of the stented artery after catheter angiography follow-up. Mean study follow-up time was 38.9 months.
During follow-up, researchers recorded 27 (11.6%) primary endpoint events. The risk for ischemic stroke or TIA was higher in the intracranial ISR group compared with non-ISR group (21.1% vs. 8.5%). The intracranial ISR group was also more likely to have an event earlier in the follow-up period than patients with non-ISR (median time to endpoint, 9.9 months vs. 26.6 months).
“Specific risk factors in the development of ISR after intracranial stenting had been described, such as age, diabetes mellitus, stent type and lesion location. In this study, we did find the proportion of patients with diabetes mellitus in ISR group was higher compared with non-ISR group,” the researchers wrote. “We interestingly found that there were more smokers in non-ISR group than ISR group, which indicated that smoking might be a beneficial factor for non-ISR.”
Disclosure: This study was funded by National Key Basic Research Program of China and Program of National Natural Science Foundation of China. The researchers report no relevant financial disclosures.