The Incidence and Risk Factors of In-Stent Restenosis for Vertebrobasilar Artery Stenting

Zheng, Dong; Zhu, Min; Shi, Wei; Li, Min; Chen, Wanhong; Dai, Qiliang; Jiang, Yanrui; Liu, Xinfeng

doi:10.1016/j.wneu.2017.11.112

Cited by 22 publications

(18 citation statements)

References 31 publications

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“…The risk factors for ISR may originate from three sources: the patients, physician skill, and stent characteristics (5,24,25). The first source includes factors such as smoking, hypertension, hyperlipidemia, atrial fibrillation, diabetes mellitus, C-reactive protein (>5 mg/l), and coronary artery disease.…”

Section: Discussionmentioning

confidence: 99%

Hybrid Recanalization for the Treatment of Carotid/Vertebral In-stent Restenosis or Occlusion: Pilot Surgery Experiences From One Single Center

et al. 2020

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Background : The hybrid recanalization of internal carotid artery (ICA) and vertebral artery (VA) in-stent restenosis or occlusion using a combination of endarterectomy and endovascular intervention has achieved technical success. We present our surgical experiences to further evaluate the safety and efficacy of the hybrid technique for the treatment of in-stent restenosis and occlusion.Methods : A cohort of 12 refractory patients with in-stent restenosis or occlusion who underwent hybrid recanalization, a combination of endarterectomy and endovascular intervention, were retrospectively analyzed. Medical records, including presenting symptoms, comorbidities, contralateral ICA/VA findings, use of antiplatelet drugs, postoperative complications, and angiographic outcomes, were collected.Results : Among 415 consecutive patients with ICA, common carotid artery, and V1 segment lesions, 12 refractory patients (2.89%) with 13 cases were enrolled in our study (1 female and 11 male). All patients underwent successful hybrid recanalization. There were no cases of postoperative stroke or death. Only two patients sustained hoarseness, but it resolved within 2 weeks after surgery. Three patients were treated with dual antiplatelet (aspirin and clopidogrel), seven with single antiplatelet (aspirin), one with single antiplatelet (clopidogrel), and one with single antiplatelet (ticagrelor). All patients were followed up in the outpatient department according to the protocol, with a mean follow-up period of 13 months (range, 6–24 months). No death or recurrent symptoms occurred during the regular follow-up period.Conclusion : The hybrid technique maybe a safe and feasible treatment option to recanalize in-stent restenosis or occlusion with acceptable complications.

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Section: Discussionmentioning

confidence: 99%

Hybrid Recanalization for the Treatment of Carotid/Vertebral In-stent Restenosis or Occlusion: Pilot Surgery Experiences From One Single Center

et al. 2020

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“…On admission, demographic information (including age and gender), stroke risks (current smoker, current drinker, hypertension, hyperlipidemia, diabetes, coronary artery disease, and previous stroke or transient ischemic attack (TIA) history) and the National Institutes of Health Stroke Scale (NIHSS) on admission were collected. Current drinkers were categorized by heavy intake (more than 14 drinks per week in women or more than 21 drinks per week in men) or episodic heavy intake (more than 5 drinks in 1 episode at least once per month) [16]. Blood tests (complete blood count, biochemistry, and coagulation profile) and cardiac examinations (electrocardiogram and echocardiogram) were also performed.…”

Section: Methodsmentioning

confidence: 99%

Topographic location of unisolated pontine infarction

et al. 2019

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Background The topographic location of acute pontine infarction is associated with clinical syndromes and prognosis. Previous studies focused on isolated pontine infarction, but the topographic location of unisolated pontine infarction has remained unclear. Methods This was a prospective, multicenter, longitudinal registry study. Patients with acute pontine infarction confirmed by magnetic resonance imaging (MRI) were enrolled. Based on the territory of the pontine artery, the topographic location was divided into anteromedial, anterolateral, tegmental, bilateral and unilateral multiple infarctions. Results From May 1, 2003, to Oct 31, 2017, 1003 patients were enrolled, and 330 had unisolated pontine infarction. For isolated pontine infarction, 44.9, 19.8, 16.0, 13.1 and 6.2% of patients had anteromedial, anterolateral, tegmental, bilateral and unilateral multiple pontine infarctions, respectively. For unisolated pontine infarction, 30.3, 19.7, 24.5, 15.2 and 10.3% of patients had anteromedial, anterolateral, tegmental, bilateral and unilateral multiple pontine infarctions, respectively. Conclusion In this large series study, our data revealed fewer anteromedial infarctions and more tegmental and unilateral multiple infarctions in patients with unisolated pontine infarction than in patients with isolated pontine infarction.

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“…4 Endovascular intervention therapy for VOAS has been widely used in clinical practice, although in-stent restenosis (ISR) in VAOS is more common than that in other arteries such as the coronary or carotid artery. 5 In a study of patients undergoing percutaneous coronary intervention, the cilostazol group receiving cilostazol plus clopidogrel had less ISR than the aspirin group receiving aspirin plus clopidogrel. 6 However, to the best of our knowledge, there has been no report describing the risk of ISR in VAOS stenting patients with gout taking cilostazol instead of aspirin in combination with clopidogrel.…”

Section: Introductionmentioning

confidence: 99%

Cilostazol plus clopidogrel in the prevention of in-stent stenosis after vertebral artery origin stenting in gout patients: three case reports

Yuan

Lin

2020

J Int Med Res

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It is unclear whether cilostazol instead of aspirin in combination with clopidogrel could prevent in-stent thrombosis in patients with a history of gout undergoing vertebral artery origin stenting. Three men (age range, 58–74 years) were diagnosed with acute ischaemic stroke or transient ischaemic attack. Vertebral artery origin stenosis was visible by computed tomographic angiography or digital subtraction angiography. Four bare metal stents were placed in the vertebral artery origin. The patients were administered 100 mg cilostazol orally twice a day and 75 mg clopidogrel orally once a day perioperatively and 100 mg cilostazol orally twice day was administered indefinitely after 3 months. No in-stent stenosis was observed in all of these patients during a follow-up period up to 19 months. Cilostazol plus clopidogrel has the potential to become an alternative to standard dual antiplatelet therapy in vertebral artery origin stenting. A high-quality clinical trial is needed to verify these preliminary findings.

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The Incidence and Risk Factors of In-Stent Restenosis for Vertebrobasilar Artery Stenting

Cited by 22 publications

References 31 publications

Hybrid Recanalization for the Treatment of Carotid/Vertebral In-stent Restenosis or Occlusion: Pilot Surgery Experiences From One Single Center

Hybrid Recanalization for the Treatment of Carotid/Vertebral In-stent Restenosis or Occlusion: Pilot Surgery Experiences From One Single Center

Topographic location of unisolated pontine infarction

Cilostazol plus clopidogrel in the prevention of in-stent stenosis after vertebral artery origin stenting in gout patients: three case reports

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