Analysis of related factors for vascular luminal dilatational remodeling after balloon angioplasty for intracranial atherosclerotic stenosis
10.3760/cma.j.cn112149-20230930-00250
- VernacularTitle:颅内动脉粥样硬化性狭窄球囊成形术后血管管腔扩张性重构的相关因素分析
- Author:
Qianhao DING
1
;
Yingkun HE
;
Jingge ZHAO
;
Yanyan HE
;
Wenbo LIU
;
Yao TANG
;
Dehua GUO
;
Tengfei ZHOU
;
Liangfu ZHU
;
Ziliang WANG
;
Tianxiao LI
Author Information
1. 郑州大学人民医院介入中心脑血管病科 河南省人民医院卒中中心神经外科 河南省神经介入研发与应用工程研究中心 河南省脑血管病国际联合实验室，郑州 450003
- Keywords:
Intracranial artery stenosis;
Balloon angioplasty;
Paclitaxel-coated balloon;
Vascular luminal dilatational remodeling
- From:
Chinese Journal of Radiology
2024;58(8):850-858
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the factors associated with vascular luminal dilatational remodeling (VLDR) following balloon angioplasty for intracranial atherosclerotic stenosis (ICAS).Methods:A case-control study was conducted to analyze the data of symptomatic severe ICAS patients who received either paclitaxel-coated balloon angioplasty (PCBA) or plain balloon angioplasty (POBA) at our center from January 2019 to January 2022 and completed the six-month follow-up. The patients were divided into VLDR group and non-VLDR group according to whether VLDR occurred on follow-up digital subtraction angiography (DSA). The baseline data, preoperative and postoperative lesion characteristics (DSA), and perioperative related information were collected. The definition of VLDR was a decrease in luminal stenosis rate by more than 10% at the time of follow-up compared to the immediate postoperative period. Multivariate logistic regression was performed to analyze possible factors affecting VLDR such as balloon type, balloon length, and expansion time.Results:A total of 88 patients were included in this study, with 16 in the VLDR group and 72 in the non-VLDR group. The follow-up time for all included patients was 6.00 (5.00, 7.00) months. VLDR occurred in 18.2% (16/88) of cases, with a VLDR incidence of 30.4% (14/46) after PCBA and 4.8% (2/42) after POBA. Univariate logistic regression analysis revealed that treatment balloon type, balloon length, inflated time, immediate postoperative stenosis rate, follow-up time and Mori classification may affect the occurrence of VLDR. Multivariate logistic regression analysis showed that the use of paclitaxel-coated balloon (PCB) ( OR=9.82, 95% CI 1.99-48.49, P=0.005) and postoperative immediate stenosis rate ( OR=1.07, 95% CI 1.00-1.14, P=0.042) were independently associated with VLDR. Conclusion:The occurrence of VLDR following balloon angioplasty in ICAS was associated with the use of PCB and immediate postoperative stenosis rates, which will provide guidance for the clinical application of PCB.
