Discover the pivotal link between cigarette smoking, in-stent carotid stenosis, and the risk of carotid restenosis in our comprehensive analysis of 738 carotid artery stenting procedures.
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Residual In-Stent Carotid Stenosis and Cigarette Smoking are Independent Predictors of Carotid Restenosis After Carotid Artery Stenting-Results from 738 Carotid Artery Stenting Procedures at a Single Center.
Lai et al., Neurosurgery 2023
DOI: 10.1227/neu.0000000000002798
Key Findings:
- The study retrospectively analyzed 1017 carotid artery stenting (CAS) procedures over 12 years to identify predictors of in-stent restenosis.
- The overall restenosis rate was 17%, with a 14% rate at 2 years.
- Significant predictors of restenosis included:
- Smoking status (OR = 2.3)
- Plaque irregularity (OR = 0.55)
- Moderate contralateral stenosis (OR = 3.2)
- Severe contralateral stenosis (OR = 2.8)
- Residual in-stent stenosis post-procedure (OR = 433)
- Patients with <28.6% initial in-stent stenosis had a 9% restenosis rate, while those with >28.6% had a 35% rate.
Importance:
This study highlights the importance of minimizing initial in-stent stenosis and addressing smoking habits to reduce the likelihood of restenosis after CAS. The findings contribute to the understanding of risk factors associated with carotid restenosis, which can inform clinical decisions and patient management strategies.
Contribution to Literature:
The research provides evidence-based predictors for in-stent restenosis, emphasizing the need for thorough initial treatment of stenosis and smoking cessation programs as preventive measures for patients undergoing CAS.