Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Research Article

Application of Color Doppler Ultrasound to Evaluate and Analyze the Risk Factors of Residual Stenosis after Vertebral Artery Origin Stenting

Author(s): Yue Han, Xi-ping Mo, Xin-yue Ge and Jian-yuan Huang*

Volume 20, 2024

Published on: 15 September, 2023

Article ID: e150923221165 Pages: 7

DOI: 10.2174/1573405620666230915125628

open_access

Abstract

Background: Vertebral artery origin stenting (VAOS) is the mainstream method for the treatment of vertebral artery stenosis (VAS). However, there are few studies on the risk factors analysis for residual stenosis after VAOS.

Purpose: This study aimed to apply color Doppler ultrasound (CDU) to evaluate and analyze the risk factors of residual stenosis after VAOS.

Methods: About 178 patients with VAOS were included from 2017 to 2019 in Liuzhou worker’s hospital and divided into the residual stenosis group (n = 38) and the no-residual stenosis group (n = 140). The clinical data and hemodynamics alteration before and after VAOS were collected. The univariate and multivariate logistic regression analysis was used to analyze the risk factors of residual stenosis.

Results: Compared with the no-residual stenosis group, the proportion of hypertension, the bending of the initial segment, and the residual stenosis length > 10 mm in the residual stenosis group were significantly higher, while the original internal diameter was significantly smaller (P < 0.05). The multivariate logistic regression analysis showed that the bending of initial segment (OR = 2.41, 95% CI: 1.32-5.45, P = 0.033), the original internal diameter (OR = 2.29, 95% CI: 1.13-5.66, P = 0.001), and the residual stenosis length > 10 mm were the risk factors of residual stenosis (OR = 2.78, 95% CI: 1.82-5.85, P = 0.044).

Conclusion: The bending of initial segment, the original internal diameter, and the residual stenosis length > 10 mm were the risk factors of residual stenosis after VAOS.

Keywords: Vertebral artery stenosis, Vertebral artery origin stenting, Color Doppler ultrasound, Residual stenosis, In-stent restenosis, Hypertension.

[1]
Gesheva SI, Hastings LH, Wilson JD. The use of aspiration catheter systems for embolic protection during intracranial vertebral artery angioplasty and stenting. Intervent Neurol 2015; 4(3-4): 113-9.
[http://dx.doi.org/10.1159/000443218] [PMID: 27051407]
[2]
Song L, Li J, Gu Y, et al. Drug-eluting vs. bare metal stents for symptomatic vertebral artery stenosis. J Endovasc Ther 2012; 19(2): 231-8.
[http://dx.doi.org/10.1583/11-3718.1] [PMID: 22545889]
[3]
Jenkins JS, Stewart M. Endovascular treatment of vertebral artery stenosis. Prog Cardiovasc Dis 2017; 59(6): 619-25.
[http://dx.doi.org/10.1016/j.pcad.2017.02.005] [PMID: 28284683]
[4]
Zheng D, Mingyue Z, Wei S, et al. The incidence and risk factors of in-stent restenosis for vertebrobasilar artery stenting. World Neurosurg 2018; 110: e937-41.
[http://dx.doi.org/10.1016/j.wneu.2017.11.112] [PMID: 29191532]
[5]
Zhou Y, Hua Y, Jia L, et al. Evaluation of interventional therapy for patients with intracranial vertebral artery stenosis by transcranial color-coded sonography. Ultrasound Med Biol 2016; 42(1): 44-50.
[http://dx.doi.org/10.1016/j.ultrasmedbio.2015.08.006] [PMID: 26410007]
[6]
Kantarci F, Mihmanli I, Albayram MS, et al. Follow-up of extracranial vertebral artery stents with Doppler sonography. AJR Am J Roentgenol 2006; 187(3): 779-87.
[http://dx.doi.org/10.2214/AJR.05.0452] [PMID: 16928945]
[7]
Hagley D, Saha P, Black S. Optimal diagnostics of residual stenosis after lysis. Phlebology 2016; 31(S1): 11-4.
[http://dx.doi.org/10.1177/0268355516632437] [PMID: 26916763]
[8]
Martinoli C, Pretolesi F, Crespi G, et al. Power doppler sonography: Clinical applications. Eur J Radiol 1998; 27(S2): S133-40.
[http://dx.doi.org/10.1016/S0720-048X(98)00054-0] [PMID: 9652513]
[9]
Hua Y, Meng XF, Jia LY, et al. Color Doppler imaging evaluation of proximal vertebral artery stenosis. AJR Am J Roentgenol 2009; 193(5): 1434-8.
[http://dx.doi.org/10.2214/AJR.09.2624] [PMID: 19843764]
[10]
Jia L, Hua Y, Li J, Duan C, Zhou Y, Jiao L. Optimal ultrasound criteria for defining the severity of vertebral artery in-stent restenosis. Ultrasound Med Biol 2015; 41(3): 775-80.
[http://dx.doi.org/10.1016/j.ultrasmedbio.2014.10.009] [PMID: 25683222]
[11]
Commission SPaTECoCHaFP. Guidelines for vascular ultrasound examination of stroke in China. Chin J Med Ultrasound 2015; 12(8): 599-610.
[12]
Parkhutik V, Lago A, Tembl JI, Aparici F, Vazquez V, Mainar E. Angioplasty and stenting of symptomatic and asymptomatic vertebral artery stenosis: To treat or not to treat. Eur J Neurol 2010; 17(2): 267-72.
[http://dx.doi.org/10.1111/j.1468-1331.2009.02786.x] [PMID: 19765054]
[13]
Jenkins JS, Patel SN, White CJ, et al. Endovascular stenting for vertebral artery stenosis. J Am Coll Cardiol 2010; 55(6): 538-42.
[http://dx.doi.org/10.1016/j.jacc.2009.08.069] [PMID: 20152558]
[14]
Schillinger M, Haumer M, Schillinger S, Ahmadi R, Minar E. Risk stratification for subclavian artery angioplasty: Is there an increased rate of restenosis after stent implantation? J Endovasc Ther 2001; 8(6): 550-7.
[http://dx.doi.org/10.1177/152660280100800603] [PMID: 11797967]
[15]
Zhou Z, Yin Q, Xu G, et al. Influence of vessel size and tortuosity on in-stent restenosis after stent implantation in the vertebral artery ostium. Cardiovasc Intervent Radiol 2011; 34(3): 481-7.
[http://dx.doi.org/10.1007/s00270-010-9953-4] [PMID: 20683721]
[16]
Zhao L, Li LF, Liu ZP, Bi W. Application of vascular morphological analysis in interventional therapy. Clinical Focus 2010; 25(23): 2095-6.
[17]
Tang X, Tang F, Hu C, Wang Q, Long W, Li L. Dynamic respiratory tortuosity of the vertebral artery ostium. J Endovasc Ther 2017; 24(1): 124-9.
[http://dx.doi.org/10.1177/1526602816676254] [PMID: 27831484]
[18]
Zhang YQ, Lv Q, Zhang WQ. Influencing factors for restenosis after vertebral artery origin atherosclerotic stenosis stenting. Chin J Geriatr Heart Brain Vessel Dis 2015; 17(1): 6-9.
[http://dx.doi.org/10.3969/j.issn.1009-0126.2015.01.002]
[19]
Jia LY, Hua Y, Li JZ, Yang J, Tang YS. Hemodynamics alteration after the vertebral artery stenting in patients with bilateral vertebral artery severe stenosis and its relationship with restenosis. Chin J Cerebrovasc Dis 2011; 8(11): 576-80.
[http://dx.doi.org/10.3969/j.issn.1672-5921.2011.11.004]
[20]
Shin YS, Kim BM, Suh SH, et al. Wingspan stenting for intracranial atherosclerotic stenosis: Clinical outcomes and risk factors for in-stent restenosis. Neurosurgery 2013; 72(4): 596-604.
[http://dx.doi.org/10.1227/NEU.0b013e3182846e09]
[21]
Polak JF, Meisner A, Pencina MJ, Wolf PA, D’Agostino RB. Variations in common carotid artery intima-media thickness during the cardiac cycle: Implications for cardiovascular risk assessment. J Am Soc Echocardiogr 2012; 25(9): 1023-8.
[http://dx.doi.org/10.1016/j.echo.2012.05.007] [PMID: 22721828]
[22]
Katano H, Mase M, Nishikawa Y, Yamada K. Surgical treatment for carotid stenoses with highly calcified plaques. J Stroke Cerebrovasc Dis 2014; 23(1): 148-54.
[http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2012.11.019] [PMID: 23273787]
[23]
Chen X, Huang Q, Hong B, Zhang Y, Xu Y, Liu J. Drug-eluting stent for the treatment of symptomatic vertebral origin stenosis: Long-term results. J Clin Neurosci 2011; 18(1): 47-51.
[http://dx.doi.org/10.1016/j.jocn.2010.05.023] [PMID: 20888236]
[24]
Antoniou GA, Murray D, Georgiadis GS, et al. Percutaneous transluminal angioplasty and stenting in patients with proximal vertebral artery stenosis. J Vasc Surg 2012; 55(4): 1167-77.
[http://dx.doi.org/10.1016/j.jvs.2011.09.084] [PMID: 22206680]
[25]
Chen W, Huang F, Li M, et al. Incidence and predictors of the in-stent restenosis after vertebral artery ostium stenting. J Stroke Cerebrovasc Dis 2018; 27(11): 3030-5.
[http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.06.031] [PMID: 30093203]

© 2024 Bentham Science Publishers | Privacy Policy