Hu Jun, Hu Na, Hu Tiemin, Zhang Jiwei, Han Dong, Wang Hong
Faculty of Integrated Traditional Chinese and Western Medicine, Hebei University of Chinese Medicine, Shijiazhuang, China.
Department of Neurosurgery, Affiliated Hospital of Chengde Medical University, Chengde, China.
Heliyon. 2023 May 25;9(6):e16220. doi: 10.1016/j.heliyon.2023.e16220. eCollection 2023 Jun.
This study investigated the association between perivascular fat density (PFD) via preoperative computed tomographic angiography (CTA) and early in-stent restenosis (ISR) after carotid artery stenting (CAS).
We retrospectively evaluated 248 consecutive patients who had undergone initial CAS and received a preoperative cervical CTA examination between January 2019 and October 2020. The patients were categorized into two according to whether they sustained ISR during the 2 years postoperative follow-up period. Correlations between PFD and ISR were assessed, and multivariate regression for evaluating predictors of ISR was conducted. Receiver operating characteristic (ROC) curves were used to determine the cutoff value for the PFD.
A total of 181 eligible patients (mean age 61.25 ± 10.35 years, 57 male) were enrolled. The ISR group had a higher proportion of closed-cell stents (48.8% versus 27.5%; = 0.009) and a greater degree of residual stenosis (28[20,33] % versus 20[14.75,30] %; < 0.001) than the non-ISR group. The ISR group had a higher mean HU value of PFD than the non-ISR group on the operated side (-42.26 ± 6.81 versus -59.66 ± 10.75; < 0.001). The degree of residual stenosis (OR 1.146, 95%CI 1.071-1.226, < 0.001) and PFD on the operated side (OR1.353, 95%CI 1.215-1.506, < 0.001) were significantly associated with the ISR.
The occurrence of the early ISR after CAS is associated with a higher PFD on the operated side. The results indicate that PFD is a promising marker to predict the ISR after CAS.
本研究通过术前计算机断层血管造影（CTA）调查血管周围脂肪密度（PFD）与颈动脉支架置入术（CAS）后早期支架内再狭窄（ISR）之间的关联。
我们回顾性评估了2019年1月至2020年10月期间连续接受初次CAS并进行术前颈部CTA检查的248例患者。根据患者在术后2年随访期间是否发生ISR将其分为两组。评估PFD与ISR之间的相关性，并进行多因素回归分析以评估ISR的预测因素。采用受试者工作特征（ROC）曲线确定PFD的临界值。
共纳入181例符合条件的患者（平均年龄61.25±10.35岁，男性57例）。与非ISR组相比，ISR组闭合细胞支架的比例更高（48.8%对27.5%；P = 0.009），残余狭窄程度更大（28[20,33]%对20[14.75,30]%；P < 0.001）。ISR组手术侧PFD的平均HU值高于非ISR组（-42.26±6.81对-59.66±10.75；P < 0.001）。残余狭窄程度（OR 1.146，95%CI 1.071 - 1.226，P < 0.001）和手术侧PFD（OR 1.353，95%CI 1.215 - 1.506，P < 0.001）与ISR显著相关。
CAS后早期ISR的发生与手术侧较高的PFD有关。结果表明，PFD是预测CAS后ISR的一个有前景的标志物。
