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Effects of plaque characteristics and artery hemodynamics on the residual stenosis after carotid artery stenting

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收录情况： ◇ SCIE

作者：
Lingyun Jia[1,2,3] * ; Yang Hua[1,2,3,*1] * ; Liqun Jiao[4] ; Yan Ma[4] ; Yingqi Xing[1,2,3,5] ; Lijuan Wang[5] ; Pinjing Hui[6] ; Xiaofang Pan[7] ; Yalan Fang[8] ; Tao Peng[9] ; Xuan Meng[10] ; Haohui Zhu[11] ; Chunxia Wu[12] ; Yuanyuan Yan[13] ; Bing Han[14] ; Jie Yang[1,2] ; Nan Zhang[1,2] ; Ke Zhang[1,2] ; Duo Xu[1,2] ;
机构： [1]Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University. [2]Beijing Diagnostic Center of Vascular Ultrasound. [3]Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, [4]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University. [5]Department of Neurology, The First Hospital of Jilin University [6]Department of Ultrasonography, The First Affiliated Hospital of Soochow University [7]Department of Ultrasonography, Dalian Municipal Central Hospital Affiliated of Dalian Medical University [8]Department of Ultrasonography, The First Affiliated Hospital of Shanxi Medical University [9]Department of Ultrasonography, The Second People s Hospital of Liaocheng [10]Department of Ultrasonography, Lanzhou University Second Hospital [11]Department of Ultrasonography, Henan Provincial Hospital [12]Department of Ultrasonography, Liaocheng Brain Hospital [13]Department of Ultrasonography, Zhengzhou Central Hospital [14]Department of Ultrasonography, Weihai Municipal Hospital
出处：
DOI： 10.1016/j.jvs.2023.03.500
ISSN：

摘要：
Carotid artery stenting (CAS) has become an alternative strategy to carotid endarterectomy (CEA) for carotid artery stenosis. Residual stenosis was an independent risk factor for restenosis, with the latter affecting the long-term outcomes of CAS. This multi-center study aimed to evaluate the echogenicity of plaques and hemodynamic alteration by color duplex ultrasound (CDU) and investigate their effects on the residual stenosis after CAS.From June 2018 to June 2020, 454 patients (386 males and 68 females) with a mean age of 67.2±7.9 years old, who underwent CAS from 11 advanced stroke centers in China were enrolled. One week before recanalization, CDU was used to evaluate the responsible plaques, including the morphology (regular or irregular), echogenicity of the plaques (iso-, hypo- or hyper-echoic) and calcification characteristics (without calcification, surperficial-calcification, inner-calcification, and basal-calcification). One-week after CAS, the alteration of diameter and hemodynamic parameters were evaluated by CDU, and the occurrence and degree of residual stenosis were determined. In addition, MRI was performed before and during the 30-days post-procedural period to identify new ischemic cerebral lesions (NICL).The rate of composite complications including cerebral hemorrhage, symptomatic NICL, and death after CAS was 1.54% (7/454 cases). The rate of residual stenosis after CAS was 16.3% (74/454 cases). After CAS, both the diameter and peak systolic velocity (PSV) improved in the pre-procedural 50-69% and 70-99% stenosis groups (P < 0.05). Compared with the groups without residual stenosis and with < 50% residual stenosis, the PSV of all three segments of stent in the 50-69% residual stenosis group were the highest, and the difference in the mid segment of stent PSV was the largest (P < 0.05). Logistic regression analysis showed that pre-procedural severe (70-99%) stenosis (OR 9.421, P=0.032), hyper-echoic plaques (OR 3.060, P=0.006）and plaques with basal calcification (OR 1.885, P=0.049) were independent risk factors for residual stenosis after CAS.Patients with hyper-echoic and calcified plaques of the carotid stenosis are at a high-risk of residual stenosis after CAS. CDU is an optimal, simple and non-invasive imaging method to evaluate plaque echogenicity and hemodynamic alterations during the perioperative period of CAS, which can help surgeons select the optimal strategies and prevent the occurrence of residual stenosis.Copyright © 2023. Published by Elsevier Inc.

基金：
This study was supported by the Stroke Prevention and Treatment of the National Health Commission-Research and Popularization of Appropriate Intervention Technology for the Stroke High- Risk Group in China (Task No. GN- 201 8R0003); data for bigdata observatory platform of stroke of China.
语种：
外文
被引次数：
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2022]版：
大类 | 2 区 医学
小类 | 2 区 外周血管病 2 区 外科
最新[2023]版：
大类 | 2 区 医学
小类 | 2 区 外周血管病 2 区 外科
JCR分区：
出版当年[2021]版：
Q1 SURGERY Q2 PERIPHERAL VASCULAR DISEASE
最新[2023]版：
Q1 PERIPHERAL VASCULAR DISEASE Q1 SURGERY

影响因子： 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

第一作者：
第一作者机构： [1]Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University. [2]Beijing Diagnostic Center of Vascular Ultrasound. [3]Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University,
共同第一作者：
通讯作者：
通讯机构： [1]Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University. [2]Beijing Diagnostic Center of Vascular Ultrasound. [3]Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, [*1]No. 45 Changchun Road, Xuanwu Hospital, Beijing 100053, China
推荐引用方式(GB/T 7714)：
Lingyun Jia,Yang Hua,Liqun Jiao,et al.Effects of plaque characteristics and artery hemodynamics on the residual stenosis after carotid artery stenting[J].JOURNAL OF VASCULAR SURGERY.2023,78(2):430-+.doi:10.1016/j.jvs.2023.03.500.
APA：
Lingyun Jia,Yang Hua,Liqun Jiao,Yan Ma,Yingqi Xing...&Duo Xu.(2023).Effects of plaque characteristics and artery hemodynamics on the residual stenosis after carotid artery stenting.JOURNAL OF VASCULAR SURGERY,78,(2)
MLA：
Lingyun Jia,et al."Effects of plaque characteristics and artery hemodynamics on the residual stenosis after carotid artery stenting".JOURNAL OF VASCULAR SURGERY 78..2(2023):430-+

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