Department of Vascular Surgery, Xuanwu Hospital Capital Medical University, Beijing, China.
Catheter Cardiovasc Interv. 2022 Aug;100(2):279-289. doi: 10.1002/ccd.30296. Epub 2022 Jun 22.
In-stent restenosis (ISR) remains a challenge in the treatment of vertebral artery V1 segment stenosis. The aim of this meta-analysis is to identify the risk factors of ISR.
Studies eligible for inclusion criteria were found in PubMed, Embase, and Cochrane Library databases. Data related to risk factors of ISR were extracted from the included studies, and pooled analysis was performed when data of the same factor were available in ≥2 studies. Dichotomous outcomes were analyzed with odds ratios (OR) and continuous outcomes were analyzed with a weighted mean difference (WMD). The Stata 14.0 program was used for the meta-analysis.
A total of 11 studies involving 1356 patients were included in our analysis. Pooled analyses showed that younger age (p = 0.01; WMD= -1.958; 95% confidence interval [CI], -3.453 to -0.463) and V1 tortuosity (p = 0.004; OR = 4.145; 95% CI, 1.56-11.012) significantly associated with higher risk of ISR in V1 segment stenting. While bare-metal stents, stent diameter and length, diabetes mellitus, coronary artery disease, and smoking were not found to increase ISR rates.
This meta-analysis showed that young age and V1 tortuosity increase the ISR rates after vertebral V1 segment stenting.
支架内再狭窄（ISR）仍然是椎动脉 V1 段狭窄治疗的挑战。本荟萃分析旨在确定 ISR 的危险因素。
在 PubMed、Embase 和 Cochrane 图书馆数据库中查找符合纳入标准的研究。从纳入的研究中提取与 ISR 危险因素相关的数据，如果同一因素有≥2 项研究的数据，则进行汇总分析。二分类结局采用比值比（OR）进行分析，连续结局采用加权均数差（WMD）进行分析。使用 Stata 14.0 程序进行荟萃分析。
共有 11 项研究纳入了 1356 名患者，纳入我们的分析。汇总分析显示，年龄较小（p=0.01；WMD=-1.958；95%置信区间[CI]，-3.453 至-0.463）和 V1 迂曲（p=0.004；OR=4.145；95%CI，1.56-11.012）与 V1 段支架置入后更高的 ISR 风险显著相关。而裸金属支架、支架直径和长度、糖尿病、冠心病和吸烟并未发现会增加 ISR 发生率。
本荟萃分析表明，年轻和 V1 迂曲会增加椎动脉 V1 段支架置入后 ISR 的发生率。
