Analysis of related factors for vascular luminal dilatational remodeling after balloon angioplasty for intracranial atherosclerotic stenosis
Qianhao Ding, Yingkun He, Jingge Zhao, Yanyan He, Wenbo Liu, Yao Tang, Dehua Guo, Tengfei Zhou, Liangfu Zhu, Ziliang Wang, Tianxiao Li
Abstract
ObjectiveTo explore the factors associated with vascular luminal dilatational remodeling (VLDR) following balloon angioplasty for intracranial atherosclerotic stenosis (ICAS).
MethodsA 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.
ResultsA 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.
ConclusionThe 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.
Key words:
Intracranial artery stenosis; Balloon angioplasty; Paclitaxel-coated balloon; Vascular luminal dilatational remodeling
Contributor Information
Qianhao Ding
Cerebrovascular Department of Interventional Center, Zhengzhou University People′s Hospital, Neurosurgery Department of Stroke Center, Henan Provincial People′s Hospital, Henan Provincial Neurointerventional Engineering Research Center, Henan International Joint Laboratory of Cerebrovascular Disease, Zhengzhou 450003, China
Yingkun He
Cerebrovascular Department of Interventional Center, Zhengzhou University People′s Hospital, Neurosurgery Department of Stroke Center, Henan Provincial People′s Hospital, Henan Provincial Neurointerventional Engineering Research Center, Henan International Joint Laboratory of Cerebrovascular Disease, Zhengzhou 450003, China
Jingge Zhao
Department of Scientific Research and Foreign Affairs, Henan Provincial People′s Hospital, Zhengzhou 450003, China
Yanyan He
Cerebrovascular Department of Interventional Center, Zhengzhou University People′s Hospital, Neurosurgery Department of Stroke Center, Henan Provincial People′s Hospital, Henan Provincial Neurointerventional Engineering Research Center, Henan International Joint Laboratory of Cerebrovascular Disease, Zhengzhou 450003, China
Wenbo Liu
Cerebrovascular Department of Interventional Center, Zhengzhou University People′s Hospital, Neurosurgery Department of Stroke Center, Henan Provincial People′s Hospital, Henan Provincial Neurointerventional Engineering Research Center, Henan International Joint Laboratory of Cerebrovascular Disease, Zhengzhou 450003, China
Yao Tang
Cerebrovascular Department of Interventional Center, Zhengzhou University People′s Hospital, Neurosurgery Department of Stroke Center, Henan Provincial People′s Hospital, Henan Provincial Neurointerventional Engineering Research Center, Henan International Joint Laboratory of Cerebrovascular Disease, Zhengzhou 450003, China
Dehua Guo
Cerebrovascular Department of Interventional Center, Zhengzhou University People′s Hospital, Neurosurgery Department of Stroke Center, Henan Provincial People′s Hospital, Henan Provincial Neurointerventional Engineering Research Center, Henan International Joint Laboratory of Cerebrovascular Disease, Zhengzhou 450003, China
Tengfei Zhou
Cerebrovascular Department of Interventional Center, Zhengzhou University People′s Hospital, Neurosurgery Department of Stroke Center, Henan Provincial People′s Hospital, Henan Provincial Neurointerventional Engineering Research Center, Henan International Joint Laboratory of Cerebrovascular Disease, Zhengzhou 450003, China
Liangfu Zhu
Cerebrovascular Department of Interventional Center, Zhengzhou University People′s Hospital, Neurosurgery Department of Stroke Center, Henan Provincial People′s Hospital, Henan Provincial Neurointerventional Engineering Research Center, Henan International Joint Laboratory of Cerebrovascular Disease, Zhengzhou 450003, China
Ziliang Wang
Cerebrovascular Department of Interventional Center, Zhengzhou University People′s Hospital, Neurosurgery Department of Stroke Center, Henan Provincial People′s Hospital, Henan Provincial Neurointerventional Engineering Research Center, Henan International Joint Laboratory of Cerebrovascular Disease, Zhengzhou 450003, China
Tianxiao Li
Cerebrovascular Department of Interventional Center, Zhengzhou University People′s Hospital, Neurosurgery Department of Stroke Center, Henan Provincial People′s Hospital, Henan Provincial Neurointerventional Engineering Research Center, Henan International Joint Laboratory of Cerebrovascular Disease, Zhengzhou 450003, China
