Correlation of computed fractional flow and in-stent restenosis in patients with intracranial atherosclerotic stenosis.

IF 4.5 1区 医学 Q1 NEUROIMAGING
Ming Wang, Wanning Zheng, Rong Zou, Jiahao Tang, Ruilin Cheng, Yuhai Gao, Ning Wang, Yuning Lu, Jens Fiehler, Adnan H Siddiqui, Jianping Xiang, Shu Wan
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引用次数: 0

Abstract

Objective: Fractional flow (FF) reserve has been developed as a gold standard for coronary intervention. Intracranial FF is also a valuable hemodynamic index to assess the severity of narrowing in intracranial atherosclerotic stenosis (ICAS). This study aims to investigate the predictive value of FF in assessing restenosis following endovascular treatment in patients with symptomatic ICAS.

Methods: This retrospective study recruited 67 patients with symptomatic ICAS who received intracranial stenting between March 2019 and January 2024. FF was measured by dedicated software (AccuICAD) before and after stenting. During follow-up, patients were categorized into two groups based on the occurrence of in-stent restenosis (ISR): ISR group and non-ISR group. Multivariate regression analysis and Kaplan-Meier survival analysis were performed to identify the predictive factors for ISR.

Results: Post-FF was significantly different between the ISR and non-ISR groups (0.84±0.09 vs 0.92±0.06, respectively, P<0.01). Univariate and multivariate Cox regression analyses identified post-FF (HR 0.0, 95% CI 0.0 to 0.08, P=0.005) and smoking (HR 3.06, 95% CI 1.02 to 9.19, P=0.047) as the two predictors of ISR. Receiver operating characteristic curve analysis confirmed the predictive value of post-FF for ISR (AUC=0.783, 95% CI 0.645 to 0.920, P=0.003), with a cut-off value of 0.94. Kaplan-Meier survival analysis further demonstrated that patients with a post-FF value >0.94 had a significantly lower incidence of ISR (P=0.001).

Conclusion: In this study, post-FF effectively predicted ISR, providing an intraoperative evaluation value for stenting in ICAS.

颅内动脉粥样硬化性狭窄患者计算分数血流与支架内再狭窄的相关性。
目的:血流分数储备(FF)已成为冠状动脉介入治疗的金标准。颅内FF也是评估颅内动脉粥样硬化性狭窄(ICAS)狭窄严重程度的有价值的血流动力学指标。本研究旨在探讨FF在评估症状性ICAS患者血管内治疗后再狭窄的预测价值。方法:本回顾性研究招募了67例在2019年3月至2024年1月期间接受颅内支架植入术的症状性ICAS患者。使用专用软件AccuICAD测量支架置入前后的FF。在随访中,根据支架内再狭窄(ISR)的发生情况将患者分为支架内再狭窄组和非支架内再狭窄组。采用多变量回归分析和Kaplan-Meier生存分析来确定ISR的预测因素。结果:ISR组与非ISR组术后ff发生率差异有统计学意义(分别为0.84±0.09 vs 0.92±0.06),P0.94组ISR发生率显著降低(P=0.001)。结论:本研究中,后ff能有效预测ISR,为ICAS支架置入提供术中评价价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.50
自引率
14.60%
发文量
291
审稿时长
4-8 weeks
期刊介绍: The Journal of NeuroInterventional Surgery (JNIS) is a leading peer review journal for scientific research and literature pertaining to the field of neurointerventional surgery. The journal launch follows growing professional interest in neurointerventional techniques for the treatment of a range of neurological and vascular problems including stroke, aneurysms, brain tumors, and spinal compression.The journal is owned by SNIS and is also the official journal of the Interventional Chapter of the Australian and New Zealand Society of Neuroradiology (ANZSNR), the Canadian Interventional Neuro Group, the Hong Kong Neurological Society (HKNS) and the Neuroradiological Society of Taiwan.
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