AUTHOR=Guo Xu , Ma Ning , Gao Feng , Mo Da-Peng , Luo Gang , Miao Zhong-Rong 

TITLE=Long-Term Risk Factors for Intracranial In-Stent Restenosis From a Multicenter Trial of Stenting for Symptomatic Intracranial Artery Stenosis Registry in China

JOURNAL=Frontiers in Neurology

VOLUME=11

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.601199

DOI=10.3389/fneur.2020.601199

ISSN=1664-2295

ABSTRACT=<p><bold>Background:</bold> For patients with symptomatic intracranial artery stenosis (sICAS), endovascular treatment has been shown to be feasible and safe in recent studies. However, in-stent restenosis (ISR) risks the recurrence of ischemic stroke. We attempt to elucidate the risk factors for ISR.</p><p><bold>Methods:</bold> We retrospectively analyzed 97 patients with sICAS from a prospective registry trial that included 20 centers from September 2013 to January 2015. Cases were classified into the ISR≥ 50% group or the ISR &lt; 50% group. The baseline characteristics and long-term follow-up were compared between the two groups. Binary logistic regression analyses were identified as an association between ISR and endovascular technique factors.</p><p><bold>Results:</bold> According to whether ISR was detected by CT angiography, 97 patients were divided into the ISR group (<italic>n</italic> = 24) and the non-ISR group (<italic>n</italic> = 73). The admission baseline features and lesion angiography characteristics were similar, while plasma hs-CRP (mg/L) was higher in the ISR≥ 50% group at admission (8.2 ± 11.4 vs. 2.8 ± 4.1, <italic>p</italic> = 0.032). Binary logistic regression analysis identified the longer stents (adjusted OR 0.816, 95% CI 0.699–0.953; <italic>p</italic> = 0.010), balloon-mounted stents (adjusted OR 5.748, 95% CI 1.533–21.546; <italic>p</italic> = 0.009), and local anesthesia (adjusted OR 6.000, 95% CI 1.693–21.262; <italic>p</italic> = 0.006) as predictors of ISR at the 1-year follow-up.</p><p><bold>Conclusions:</bold> The longer stents, balloon-mounted stents implanted in the intracranial vertebral or basilar artery, and local anesthesia were significantly associated with in-stent restenosis. Further studies are required to identify accurate biomarkers or image markers associated with ISR in ICAS patients.</p><p><bold>Clinical Trial Registration:</bold><ext-link ext-link-type="uri" xlink:href="http://www.ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">www.ClinicalTrials.gov</ext-link>, identifier: NCT01968122.</p>