A Risk Predictor Of Restenosis After Superficial Femoral Artery Stent Implantation

Objective : To investigate the relationship between an increase in the pre-and post-operative mean platelet volume and superficial femoral artery in-stent restenosis rate.Methods : We recruited patients that underwent superficial femoral artery stenting for lower extremity arteriosclerosis obliterans at the Fourth Affiliated Hospital of the China Medical University from September 2017 to October 2019.All patients donated venous blood three days before and then after implantation.Routine hematological parameters including erythrocytic count,hemoglobin,leukocyte count,neutrophil count,neutrophil ratio,lymphocyte count,lymphocyte ratio,eosinophil count,eosinophil ratio,basophil count,basophils ratio,platelet distribution width,platelet count,mean platelet volume,uric acid levels,creatinine levels,and levels of triglycerides,cholesterol,high-density lipoprotein,low-density lipoprotein,and serum glucose.Doppler ultrasonography,computed tomography angiography or digital subtraction angiography were performed every 3-6 months after stenting the superficial femoral artery.Logistic regression was used to identify predictors of in-stent restenosis rate after superficial femoral artery stenting.Kaplan-meier analysis was used to compare the cumulative risk of restenosis between groups Results : We enrolled 173 patients,of which 34(19.6%)were determined as having in-stent restenosis rate for a mean of 8.9 ± 2.7 months(3-12 months).Neutrophil count,neutrophil ratio,lymphocyte ratio and platelet count pre-implantation,and platelet count and mean platelet volume after stent implantation,and the pre-and post-operative mean platelet volume difference and mean platelet volume difference ratio were all statistically different when comparing the in-stent restenosis rate and non-restenosis groups(p<0.05).A positive correlation was found for post-operative mean platelet volume and presence of in-stent restenosis rate(r = 0.58;P<0.001).An mean platelet volume difference not less than 1.5 fL was associated with an odds ratio of 9.34(95% CI [3.71 to 23.48];P<0.001)for presence of in-stent restenosis rate.An mean platelet volume difference ratio of not less than 17.9% was associated with an odds ratio of 8.22(95% CI [3.32 to 20.36];P<0.001)for occurrence of in-stent restenosis rate.Conclusions: the increase in pre-and post-operative stent implantation mean platelet volume was positively correlated with the occurrence of superficial femoral artery in-stent restenosis.When an mean platelet volume difference of not less than 1.5 fL is found,or when an mean platelet volume difference ratio of not less than 17.9 percent is found,the appearance of superficial femoral artery stent restenosis is more likely to occur.