Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People's Republic of China.
Department of Interventional Neuroradiology, Beijing TianTan Hospital, Capital Medical University, Beijing, People's Republic of China.
Neurosurgery. 2022 Dec 1;91(6):943-951. doi: 10.1227/neu.0000000000002142. Epub 2022 Sep 21.
In-stent stenosis (ISS) is a delayed complication that can occur after pipeline embolization device use when treating intracranial aneurysms (IAs).
To assess the incidence, predictors, and outcomes of ISS.
This was a retrospective, multicenter, observational study. All patient data were collected from a PLUS registry study. We collected data from patients with IA who completed digital subtraction angiography at follow-up and divided patients into "non-ISS," "mild ISS," or "severe ISS" groups. Multivariate logistic regression analysis was conducted to determine predictors of ISS.
A total of 1171 consecutive patients with 1322 IAs participated in this study. Angiographic follow-up was available for 662 patients with 728 IAs, and the mean follow-up time was 9 months. ISS was detected in 73 cases (10.03%), including 61 mild ISS cases and 12 severe ISS cases. Univariate and multivariable analysis demonstrated that current smoking history (mild ISS: OR 2.15, 95% CI 1.122-4.118, P = .021; severe ISS: OR 5.858, 95% CI 1.186-28.93, P = .030) and cerebral atherosclerosis (mild ISS: OR 5.694, 95% CI 3.193-10.15, P = .001; severe ISS: OR 6.103, 95% CI 1.384-26.91, P = .017) were independent predictors of ISS. Compared with the other groups, the severe ISS group had higher rate of ischemic stroke (33.3%).
ISS occurs in approximately 10.03% of cases at a mean follow-up of 9 months. Statistically, current smoking history and cerebral atherosclerosis are the main predictors of ISS. Severe ISS may be associated with higher risk of neurological ischemic events in patients with IA after pipeline embolization device implantation.
在颅内动脉瘤（IA）治疗中使用Pipeline 栓塞装置后，可能会发生支架内狭窄（ISS），这是一种迟发性并发症。
评估 ISS 的发生率、预测因素和结局。
这是一项回顾性、多中心、观察性研究。所有患者数据均来自 PLUS 注册研究收集。我们收集了完成随访时数字减影血管造影的 IA 患者的数据，并将患者分为“非 ISS”、“轻度 ISS”或“重度 ISS”组。进行多变量逻辑回归分析以确定 ISS 的预测因素。
共有 1171 例连续患者的 1322 个 IA 参与了这项研究。662 例患者的 728 个 IA 有血管造影随访，平均随访时间为 9 个月。73 例（10.03%）发现 ISS，其中 61 例为轻度 ISS，12 例为重度 ISS。单变量和多变量分析表明，目前吸烟史（轻度 ISS：OR 2.15，95%CI 1.122-4.118，P =.021；重度 ISS：OR 5.858，95%CI 1.186-28.93，P =.030）和脑动脉粥样硬化（轻度 ISS：OR 5.694，95%CI 3.193-10.15，P =.001；重度 ISS：OR 6.103，95%CI 1.384-26.91，P =.017）是 ISS 的独立预测因素。与其他组相比，重度 ISS 组缺血性脑卒中发生率较高（33.3%）。
在平均 9 个月的随访中，约有 10.03%的病例发生 ISS。统计学上，目前吸烟史和脑动脉粥样硬化是 ISS 的主要预测因素。在 Pipeline 栓塞装置植入后，重度 ISS 可能与 IA 患者发生神经缺血性事件的风险增加有关。
