Prognostic factors for in-stent restenosis after cerebrovascular stent implantation among ischemic stroke patients...

introduction: Cerebrovascular stent implantation is an established treatment for revascularization, but the benefits of cerebrovascular stent implantation are highly affected by the incidence of in-stent restenosis. We aimed to prospectively investigate the influence of clinical factors on the in-stent restenosis after cerebrovascular stent implantation. materials and methods: We consecutively recruited 251 ischemic stroke patients treated with cerebrovascular stenting in the Second Affiliated Hospital of Hainan Medical College from November 2014 to March 2020. The study outcome was in-stent restenosis within 12 months after cerebrovascular stenting. Univariate logistic regression analysis, stepwise regression analysis, and receiver operating characteristic (ROC) curves were performed to assess the associations between clinical factors and the risk of in-stent restenosis after cerebrovascular stenting. results: Univariate logistic regression analysis showed that hypertension (odds ratio [OR], 2.15; 95% confidence interval [CI], 1.02-4.55; P=0.045), neutral-lymphocyte ratio (NLR) (OR, 1.10; 95% CI, 1.00-1.20; P=0.040), stenosis length (OR, 0.95; 95% CI, 0.90-1.00; P=0.032), and vertebral artery stenosis (OR, 3.30; 95% CI, 1.76-6.19; Pamp;lt;0.001) were associated with risk of in-stent restenosis after cerebrovascular stenting. Stepwise regression analysis selected three independent factors (i.e., hypertension, NLR, and stenosis location) to construct a predictive model for incident in-stent restenosis after cerebrovascular stenting, and the area under ROC curve of in-stent restenosis in this predictive model were 0.736 for cerebrovascular stenting, 0.621 for vertebral artery stenting, and 0.775 for internal carotid artery stenting. discussion: In this prospective cohort study, we investigated the associations of clinical factors with the risk of in-stent restenosis after cerebrovascular stenting. According to our results, hypertension and NLR were potential predictive factors for in-stent restenosis after cerebrovascular stent implantation. In addition, patients with vertebral artery stenosis had higher risk of in-stent restenosis than those with internal carotid artery stenosis. These findings may contribute to a more comprehensive understanding of the in-stent restenosis process and refine the risk prediction of in-stent restenosis. conclusion: Hypertension and NLR were potential predictive factors for in-stent restenosis after cerebrovascular stent implantation. In addition, patients with vertebral artery stenosis had higher risk of in-stent restenosis than those with internal carotid artery stenosis. Further studies were needed to confirm our findings and identify more factors associated with in-stent restenosis.