Determinants of In-Stent Restenosis after Carotid Angioplasty: A Case-Control Study

Setacci, Carlo; Pula, Giorgio; Baldi, Irene; Donato, G de; Setacci, Francesco; Cappelli, Alessandro; Pieraccini, Massimo; Cremonesi, Alberto; Castriota, Fausto; Neri, Eugénio

doi:10.1177/152660280301000602

Cited by 43 publications

(11 citation statements)

References 42 publications

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“…Other studies evaluating the impact of premorbid risk factors on complications have found significant risk from diabetes 34. However, our results and an earlier study by Setacci et al 21 found no correlation with vascular risk factors.…”

Section: Discussioncontrasting

confidence: 84%

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The myth of restenosis after carotid angioplasty and stenting

Moon

Albuquerque

Levitt

et al. 2015

J NeuroIntervent Surg

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Section: Discussioncontrasting

confidence: 84%

“…Several other studies have also reported higher rates of ISR in patients with hostile-neck lesions 20–23. This has been disputed by a report by Eskandari et al , in which the rate of ISR in patients with hostile-neck lesions was not significantly higher than in patients with atherosclerotic lesions (4.5% vs 2.0%, respectively) 21 24…”

Section: Discussionmentioning

confidence: 91%

The myth of restenosis after carotid angioplasty and stenting

Moon

Albuquerque

Levitt

et al. 2015

J NeuroIntervent Surg

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“…Specific risk factors in the development of restenosis after CAS remains to be elucidated: some studies have identified advanced age [27, 28], hyperglycemia [27, 29], smoke [27] and previous CEA [30]. In our study group, out of all the evaluated clinical radiological and procedural variables, multivariate analysis reveal that the residual stenosis after CAS is a stronger predictor of restenosis with a consistent increased risk of restenosis (1.091 per % unit of residual stenosis).…”

Section: Discussionmentioning

confidence: 99%

In Stent Restenosis Predictors after Carotid Artery Stenting

Cosottini

Michelassi

Bencivelli

et al. 2010

Stroke Research and Treatment

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Purpose. The long-term efficacy of carotid artery stenting is debated. Predictors of stent restenosis are not fully investigated. Our aim was to assess the incidence of long term restenosis after CAS and to identify some predictors of restenosis. Methods. We retrospectively selected 189 treated patients and we obtained the survival Kaplan-Meier curves for overall survival, for freedom from stroke or death and from restenosis. To correlate clinical, radiological, and procedural variables to stent restenosis, an univariate analysis was performed while to determine independent predictors of restenosis, a multivariate analysis was applied. Results. At 1, 3, and 5 years, the cumulative overall survival rate was 98%, 94%, and 92% with a cumulative primary patency rate of 87%, 82.5%, and 82.5%. The percentage residual stenosis after CAS and multiple stents deployment were independent predictors of restenosis, while diabetes and tumors are suggestive but not significant predictors of restenosis. Conclusions. In our CAS experience, encouraging long-term results seem to derive from both neurological event free rate and restenosis incidence. Adequate recanalization of the treated vessel is important to limit the development of stent restenosis. Multiple stents deployment, and with less evidence, diabetes, or neoplasms has to be considered to facilitate restenosis.

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“…Suggested predictors of restenosis after CAS are advanced age [23], female gender [23], prior revascularization treatment [24,25], asymptomatic lesion [26], suboptimal technical result with residual stenosis [24], use of balloon-expandable stents [26], implantation of multiple stents [23], and elevated postprocedural serum levels of acute-phase reactants [24]. The definite role of these factors has not yet been confirmed in large studies.…”

Section: Discussionmentioning

confidence: 99%

Postprocedural high‐density lipoprotein cholesterol predicts carotid stent patency at 1 year

Topakian¹,

Sonnberger

Nußbaumer

et al. 2008

Euro J of Neurology

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The durability of carotid artery stenting (CAS) is affected by the occurrence of myointimal proliferation and in-stent restenosis (ISR). We aimed to identify clinical, angiographic, and laboratory predictors of ISR, paying special attention to postprocedural metabolic factors. A total of 102 consecutive patients with successful CAS for > or =70% atherosclerotic internal carotid artery stenosis were followed up with neurological assessment and duplex sonography 1 day, 1 month, and 1 year after CAS. Lipid profile and hemoglobin A(1c) were tested at the 1-month follow-up visit. Ten (10%) patients had ISR > or =50% after 1 year. Compared with patients without ISR (n = 92), patients with ISR were more often current smokers (33% vs. 70%, P = 0.034) and had significantly lower 1-month high-density lipoprotein (HDL) cholesterol: median (range) 47 (24-95) mg/dl vs. 39.5 (25-50) mg/dl, P = 0.031. Multivariate logistic regression analyses identified 1-month HDL cholesterol >45 mg/dl as the only independent predictor of carotid stent patency at 1 year (P = 0.033, OR = 0.09, 95% CI 0.01-0.83). Postprocedural HDL cholesterol levels predict carotid stent patency at 1 year. With the possibility of elevation of HDL cholesterol by lifestyle changes and medication, this finding may have implications for the future management of patients undergoing CAS.

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Determinants of In-Stent Restenosis after Carotid Angioplasty: A Case-Control Study

Cited by 43 publications

References 42 publications

The myth of restenosis after carotid angioplasty and stenting

The myth of restenosis after carotid angioplasty and stenting

In Stent Restenosis Predictors after Carotid Artery Stenting

Postprocedural high‐density lipoprotein cholesterol predicts carotid stent patency at 1 year

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