title: Risk factor impact on blood flow velocities and clinical outcomes of stented cervical and intracranial stenoses: preliminary observations.
abstract: OBJECTIVE
  The role of angioplasty/stenting procedures, neurointerventionist experience, vascular risk factors, medical treatment and blood flow velocities were analysed to identify possible causes of intra-stent restenosis (ISR) following stenting of cervical and/or intracranial arteries, assuming progressive atherosclerosis to be the shared mechanism in both territories. Patients. 26 cerebrovascular patients subjected to stenting of severe (≥85%) symptomatic or asymptomatic carotid stenoses or moderate-to-severe (≥50%) intracranial or vertebral stenoses were included.
  
  
  METHODS
  Clinical, radiological and ultrasonographic follow-up data were analysed retrospectively.
  
  
  RESULTS
  Overall, stenting of the internal carotid artery (ICA) induced significant reductions in peak systolic velocities at 2 years (96±31 cm/s vs. 358.2±24.9 cm/s at baseline). The procedure-related ischemic complications rate was 7.4% (one hemispheric stroke and one TIA). The rate of ISR≤50% was 8% in the ICA at 2 years; was 50% in the common carotid artery (CCA) at 1 year, with concomitant distal ICA stenosis in 75% of CCA stenting, but all ISR were asymptomatic. Patients with ISR of the ICA were significantly younger (56.8±4.5 vs. 71.3±3.6 years, P=0.042) and had significantly more risk factors (5.5±0.9 vs. 3±0.3, P=0.012). No ISR≥70% was detected.
  
  
  CONCLUSIONS
  ISR is relatively infrequent and, when present, it is mild and asymptomatic. Restenosis is more frequent in younger patients and those with several risk factors, and it may also be related to stenting of previous carotid endarterectomy.
authors.affiliation: Department of Neurology, R1:04, Karolinska University Hospital Solna, SE-17176 Stockholm, Sweden. tiago.taborda-prazeres-moreira@karolinska.se
authors.forename: Tiago
authors.initials: T
authors.lastname: Moreira
authors.forename: Patrik
authors.initials: P
authors.lastname: Michel
authors.forename: Stefano
authors.initials: S
authors.lastname: Binaghi
authors.forename: Lorenz
authors.initials: L
authors.lastname: Hirt
mesh_terms: D000368:Aged; D020757:Amaurosis Fugax / Q000209:etiology; D017130:Angioplasty; D016893:Carotid Stenosis / Q000503:physiopathology / Q000601:surgery; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation; D002983:Clinical Competence; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000453:epidemiology; D006801:Humans; D020765:Intracranial Arterial Diseases / Q000503:physiopathology* / Q000601:surgery*; D002537:Intracranial Arteriosclerosis / Q000503:physiopathology / Q000601:surgery; D020766:Intracranial Embolism / Q000517:prevention & control; D002546:Ischemic Attack, Transient / Q000209:etiology; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D020521:Stroke / Q000209:etiology; D018616:Ultrasonography, Doppler, Duplex; D014656:Vascular Surgical Procedures / Q000193:education / Q000379:methods*
chemical_list: D010975:Platelet Aggregation Inhibitors