Abstract:
ObjectiveTo investigate the influencing factors of restenosis after stent implantation in patients with severe stenosis of middle cerebral artery (MCA) and the analysis of the best beneficiary population.
MethodsA total of 142 patients with severe MCA stenosis were studied retrospectively.The patients with severe MCA stenosis diagnosed by computed tomography angiography or digital subtraction angiography were followed up for one year.The patients were divided into no restenosis group and restenosis group.The incidence of restenosis, neurological deficit and activities of daily living before and after treatment, blood flow velocity of MCA stenosis were followed up, and the influencing factors of postoperative restenosis were analyzed.
ResultsAfter one year follow-up, the restenosis rate was 16.20%.The National Institutes of Health stroke scale (NIHSS) after treatment was lower than that before treatment, and the Barthel index was higher than that before treatment (P < 0.01).The end diastolic blood flow velocity and peak systolic blood flow velocity after treatment were lower than those before treatment (P < 0.01).There were significant differences between the two groups in morphological classification, type of passage, smoking, type 2 diabetes, transient ischemic attack, postoperative residual stenosis and stenosis degree (P < 0.05 to P < 0.01).There was no significant difference in site classification, gender, age, hypertension, hyperlipidemia and coronary heart disease (P>0.05).By multivariate logistic regression analysis, smoking, type 2 diabetes, transient ischemic attack and postoperative residual stenosis were the risk factors for restenosis (P < 0.01).
ConclusionsApollo stent implantation in patients with severe stenosis of MCA can significantly reduce the incidence of restenosis and neurological deficit, improve the daily life of patients, improve blood flow speed.Morphological classification, pathway classification, smoking, type 2 diabetes, transient ischemic attack, postoperative residual stenosis and the degree of stenosis are the influencing factors for the occurrence of restenosis after surgery.Among them, smoking, type 2 diabetes, transient ischemic attack, postoperative residual stenosis are predictors of postoperative restenosis, and the patients without predictive factors are the best beneficiaries.