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
Study Summary:
A retrospective review of 1017 carotid artery stenting (CAS) procedures over 12 years identified a 17% overall rate of radiographic restenosis. The study aimed to pinpoint clinical, radiographic, and procedural predictors for in-stent restenosis. Factors significantly associated with restenosis included smoking status, plaque irregularity, contralateral stenosis, and the degree of residual in-stent stenosis post-procedure. Specifically, patients with less than 28.6% initial in-stent stenosis had a 9% restenosis rate, while those with more than 28.6% had a 35% rate.
Importance:
This research is important as it provides evidence that certain factors, such as smoking and initial treatment effectiveness, are critical in predicting the likelihood of restenosis after CAS. This information can guide clinicians in identifying at-risk patients and tailoring post-procedural care to minimize restenosis risks.
Contribution to Literature:
The study contributes to the literature by quantifying the impact of residual in-stent stenosis and smoking on the risk of restenosis, offering a predictive model with an area under the curve of 0.78. It underscores the importance of thorough initial stent placement and smoking cessation in improving CAS outcomes.