G Peng1, Y Zhang1,2, Z Miao3,4. 1. From the Interventional Neuroradiology Center (G.P., Y.Z., Z.M.), Beijing Tiantan Hospital. 2. Beijing Neurosurgical Institute (Y.Z.), Capital Medical University, Beijing, China. 3. From the Interventional Neuroradiology Center (G.P., Y.Z., Z.M.), Beijing Tiantan Hospital zhongrongm@163.com. 4. China National Clinical Research Center for Neurological Diseases (Z.M.), Beijing, China.
Abstract
BACKGROUND: In-stent restenosis affects long-term outcome in patients with intracranial atherosclerotic stenosis. PURPOSE: The aim of this meta-analysis was to evaluate the incidence and risk factors of in-stent restenosis. DATA SOURCES: All literature that reported in-stent restenosis was searched on PubMed, Ovid EMBASE and Ovid MEDLINE data bases. STUDY SELECTION: Original articles about stents for symptomatic intracranial atherosclerotic stenosis were selected. DATA ANALYSIS: Meta-analysis was conducted to derive the pooled in-stent restenosis using a random-effects model. Meta-regression was performed to explore the risk factors predisposing to in-stent restenosis. DATA SYNTHESIS: In total, 51 studies with 5043 patients were included. The pooled incidence rate of in-stent restenosis was 14.8% (95% CI, 11.9%-17.9%). Among the lesions with in-stent restenosis, 28.8% of them led to (95% CI, 22.0%-36.0%) related neurologic symptoms. The series in the United States had a higher in-stent restenosis rate (27.0%; 95% CI, 20.6%-33.9%) compared with those from Asia (13.6%; 95% CI, 10.3%-17.2%) and other regions as a whole (7.6%; 95% CI, 1.1%-18.1%) (P < .01). Multiregression analysis revealed that younger patient age was related to high in-stent restenosis rates (P = .019), and vertebrobasilar junction location (P = .010) and low residual stenosis (P = .018) were 2 independent risk factors for symptomatic in-stent restenosis rate. LIMITATIONS: The heterogeneity of most outcomes was high. CONCLUSIONS: Our study showed promising results of in-stent restenosis for symptomatic atherosclerotic stenosis. Studies are needed to further expatiate on the mechanisms by which younger patient age, vertebrobasilar junction location, and low residual stenosis could increase in-stent restenosis and symptomatic in-stent restenosis, respectively.
BACKGROUND: In-stent restenosis affects long-term outcome in patients with intracranial atherosclerotic stenosis. PURPOSE: The aim of this meta-analysis was to evaluate the incidence and risk factors of in-stent restenosis. DATA SOURCES: All literature that reported in-stent restenosis was searched on PubMed, Ovid EMBASE and Ovid MEDLINE data bases. STUDY SELECTION: Original articles about stents for symptomatic intracranial atherosclerotic stenosis were selected. DATA ANALYSIS: Meta-analysis was conducted to derive the pooled in-stent restenosis using a random-effects model. Meta-regression was performed to explore the risk factors predisposing to in-stent restenosis. DATA SYNTHESIS: In total, 51 studies with 5043 patients were included. The pooled incidence rate of in-stent restenosis was 14.8% (95% CI, 11.9%-17.9%). Among the lesions with in-stent restenosis, 28.8% of them led to (95% CI, 22.0%-36.0%) related neurologic symptoms. The series in the United States had a higher in-stent restenosis rate (27.0%; 95% CI, 20.6%-33.9%) compared with those from Asia (13.6%; 95% CI, 10.3%-17.2%) and other regions as a whole (7.6%; 95% CI, 1.1%-18.1%) (P < .01). Multiregression analysis revealed that younger patient age was related to high in-stent restenosis rates (P = .019), and vertebrobasilar junction location (P = .010) and low residual stenosis (P = .018) were 2 independent risk factors for symptomatic in-stent restenosis rate. LIMITATIONS: The heterogeneity of most outcomes was high. CONCLUSIONS: Our study showed promising results of in-stent restenosis for symptomatic atherosclerotic stenosis. Studies are needed to further expatiate on the mechanisms by which younger patient age, vertebrobasilar junction location, and low residual stenosis could increase in-stent restenosis and symptomatic in-stent restenosis, respectively.
Authors: Adnan I Qureshi; Haitham M Hussein; Ahmed El-Gengaihy; Mohamed Abdelmoula; M Fareed K Suri Journal: Neurosurgery Date: 2008-05 Impact factor: 4.654
Authors: Marc I Chimowitz; Michael J Lynn; Harriet Howlett-Smith; Barney J Stern; Vicki S Hertzberg; Michael R Frankel; Steven R Levine; Seemant Chaturvedi; Scott E Kasner; Curtis G Benesch; Cathy A Sila; Tudor G Jovin; Jose G Romano Journal: N Engl J Med Date: 2005-03-31 Impact factor: 91.245
Authors: Marios Psychogios; Alex Brehm; Elena López-Cancio; Gian Marco De Marchis; Elena Meseguer; Aristeidis H Katsanos; Christine Kremer; Peter Sporns; Marialuisa Zedde; Adam Kobayashi; Jildaz Caroff; Daniel Bos; Sabrina Lémeret; Avtar Lal; Juan F Arenillas Journal: Eur Stroke J Date: 2022-06-03