Influential Factors Of Restenosis After Stent Implantation In Patients With Cranial Artery Stenosis

Objective: This study explored the related factors of restenosis within one year after stent implantation from the aspects of stenting factors,patients' own risk factors and postoperative medication compliance,so as to facilitate clinical prevention and treatment of stents.Restenosis provides a basis for improving the prognosis of patients with cranial artery stenting,so as to provide a basis for clinical prevention and treatment of in-stent restenosis,improve the prognosis of patients with cranial artery stenting.Method: A total of 210 patients with ischemic cerebrovascular disease who underwent cerebral vascular stenting in the Department of Neurology,Central Hospital of Cangzhou City from August 2009 to December 2012 were enrolled.All patients were diagnosed as intracranial artery stenosis by cerebral angiography(digital subtraction angiography,DSA)and successfully received arterial stenting,who received DSA,magnetic resonance angiography(MRA)or CT cerebrovascular imaging(CT cerebral angiography CTA)within one year after surgery.According to the degree of restenosis after surgery,patients with stents with stenosis more than 30% were included in the observation group,and patients with stenosis less than 30% were included in the control group.All patients underwent regular follow-up and irregular outpatient visits at 1,3,6 and 12 months after surgery.The relevant datas were collected to compare the basic datas,hematological parameters,stent factors and medication status of the two groups,assess the protective factors and risk factors for restenosis after stent implantation in patients with cranial artery stenosis.Result:1.The incidence of restenosis was 29.52% after stent placement within one year.The proportion of patients with smoking history,diabetes and dyslipidemia was significantly higher in the observation group than in the control group.The difference was statistically significant(P< 0.05).2.The proportion of metal stents,the ratio of high-density lipoprotein ?1.04mmol·L-1 at follow-up,the level of homocysteine at the time of follow-up ratio in the observation group is significantly higher than the control group,and the difference was statistically significant(P<0.05).The proportion of stent length <15mm and the proportion of postoperative standard antiplatelet treatment in the observation group were significantly lower than the control group,and the difference was statistically significant(P<0.05).3.Multivariate analysis revealed previous history of smoking,history of diabetes,dyslipidemia,postoperative stent type,high-density lipoprotein levels at follow-up,blood homocysteine levels,stent length,and postoperative standard antiplatelet therapy are all relevant factors affecting restenosis after stent implantation in patients with cranial artery stenosis(P<0.05).Conclusion:1.The middle cerebral artery stenosis is dominant,followed by vertebral artery stenosis in the patients with ischemic cerebrovascular disease and intracranial stenosis undergoing stenting,and most of them are symptomatic severe stenosis.2.High-density lipoprotein levels and blood homocysteine levels in patients with cranial artery stenosis are closely related to the occurrence of restenosis.High-density lipoprotein levels are negatively correlated with restenosis in patients.High blood homocysteine levels increase the risk of in-stent restenosis in patients after surgery.Postoperative standard antiplatelet therapy reduces the probability of restenosis in patients after surgery.The patient's blood homocysteine level should be actively controlled after stent placement in the clinical.3.Patients with ischemic cerebrovascular disease who have a history of diabetes,dyslipidemia or smoking history is prone to in-stent restenosis after stent implantation.The type of stent and the length of stent will affect the occurrence of restenosis after the stent placement in patients with cranial artery stenosis.