Abstract | BACKGROUND: In- stent restenosis affects long-term outcome in patients with intracranial atherosclerotic stenosis. PURPOSE: The aim of this meta-analysis was to evaluate the incidence and risk factors of in- stent restenosis. DATA SOURCES: All literature that reported in- stent restenosis was searched on PubMed, Ovid EMBASE and Ovid MEDLINE data bases. STUDY SELECTION: Original articles about stents for symptomatic intracranial atherosclerotic stenosis were selected. DATA ANALYSIS: Meta-analysis was conducted to derive the pooled in- stent restenosis using a random-effects model. Meta-regression was performed to explore the risk factors predisposing to in- stent restenosis. DATA SYNTHESIS: In total, 51 studies with 5043 patients were included. The pooled incidence rate of in- stent restenosis was 14.8% (95% CI, 11.9%-17.9%). Among the lesions with in- stent restenosis, 28.8% of them led to (95% CI, 22.0%-36.0%) related neurologic symptoms. The series in the United States had a higher in- stent restenosis rate (27.0%; 95% CI, 20.6%-33.9%) compared with those from Asia (13.6%; 95% CI, 10.3%-17.2%) and other regions as a whole (7.6%; 95% CI, 1.1%-18.1%) (P < .01). Multiregression analysis revealed that younger patient age was related to high in- stent restenosis rates (P = .019), and vertebrobasilar junction location (P = .010) and low residual stenosis (P = .018) were 2 independent risk factors for symptomatic in- stent restenosis rate. LIMITATIONS: The heterogeneity of most outcomes was high. CONCLUSIONS: Our study showed promising results of in- stent restenosis for symptomatic atherosclerotic stenosis. Studies are needed to further expatiate on the mechanisms by which younger patient age, vertebrobasilar junction location, and low residual stenosis could increase in- stent restenosis and symptomatic in- stent restenosis, respectively.
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Authors | G Peng, Y Zhang, Z Miao |
Journal | AJNR. American journal of neuroradiology
(AJNR Am J Neuroradiol)
Vol. 41
Issue 8
Pg. 1447-1452
(08 2020)
ISSN: 1936-959X [Electronic] United States |
PMID | 32732271
(Publication Type: Journal Article, Meta-Analysis, Systematic Review)
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Copyright | © 2020 by American Journal of Neuroradiology. |
Topics |
- Aged
- Endovascular Procedures
(methods)
- Female
- Humans
- Incidence
- Intracranial Arteriosclerosis
(complications, surgery)
- Ischemic Stroke
(etiology)
- Male
- Middle Aged
- Postoperative Complications
(epidemiology, etiology)
- Recurrence
- Risk Factors
- Stents
- Treatment Outcome
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