Zapata-Arriaza Elena, Moniche Francisco, González Alejandro, Bustamante Alejandro, Escudero-Martínez Irene, De la Torre Laviana Francisco Javier, Prieto María, Mancha Fernando, Montaner Joan
From the Neurology Department, Biomedicine Institute of Seville (IBIS) (E.Z.-A., F.M., I.E.-M., F.J.D.l.T.L., M.P., F.M., J.M.), and Radiology Department, Interventional Neuroradiology Unit (A.G.), University Hospital Virgen del Rocio, Seville, Spain; and Neurovascular Research Laboratory, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain (A.B.).
Stroke. 2016 Aug;47(8):2144-7. doi: 10.1161/STROKEAHA.116.012650. Epub 2016 Jun 21.
Restenosis after carotid angioplasty (with or without stent) is associated with increased rate of stroke and death. Our aim was to determine risk and predictive factors related to carotid restenosis post carotid angioplasty and its association to recurrent cerebrovascular events.
All consecutive patients with carotid stenosis treated with angioplasty (n=1060) in a single University Hospital were included (from 2002 to 2013). Follow-up was done prospectively evaluating restenosis, ipsilateral stroke, or death. Restenosis was defined as a narrowing of ≥70% of a previously treated vessel evaluated by ultrasonography.
Of the 1060 patients treated, 9.2% (97) of patients experienced restenosis during follow up (median 12 [9-32] months). Occurrence of restenosis was associated with ipsilateral stroke during follow-up (P=0.049). After Cox regression analysis, hypertension (hazard ratio, 6.2 [1.9-19.9]; P=0.002), impaired vasoreactivity (hazard ratio, 1.7 [1.09-2.8]; P=0.019), and angioplasty without stent (hazard ratio, 2.9 [1.2-6.8]; P=0.012) were independent risk predictors of >70% restenosis.
Carotid restenosis after carotid angioplasty is associated with ipsilateral stroke occurrence. In our sample, hypertension, angioplasty without stent, and impaired vasoreactivity identify patients at high risk of restenosis and could help to select patients for follow-up ultrasonography imaging.
颈动脉血管成形术（无论是否置入支架）后再狭窄与中风和死亡率增加相关。我们的目的是确定与颈动脉血管成形术后颈动脉再狭窄相关的风险和预测因素及其与复发性脑血管事件的关联。
纳入一所大学医院中所有连续接受血管成形术治疗的颈动脉狭窄患者（n = 1060）（2002年至2013年）。进行前瞻性随访，评估再狭窄、同侧中风或死亡情况。再狭窄定义为经超声检查评估，先前治疗的血管狭窄≥70%。
在接受治疗的1060例患者中，9.2%（97例）患者在随访期间出现再狭窄（中位时间12 [9 - 32]个月）。随访期间再狭窄的发生与同侧中风相关（P = 0.049）。经过Cox回归分析，高血压（风险比，6.2 [1.9 - 19.9]；P = 0.002）、血管反应性受损（风险比，1.7 [1.09 - 2.8]；P = 0.019）以及未置入支架的血管成形术（风险比，2.9 [1.2 - 6.8]；P = 0.012）是再狭窄>70%的独立风险预测因素。
颈动脉血管成形术后颈动脉再狭窄与同侧中风的发生相关。在我们的样本中，高血压、未置入支架的血管成形术和血管反应性受损可识别出再狭窄高危患者，并有助于选择进行随访超声成像检查的患者。
