Influence of Vertebrobasilar Stenotic Lesion Rigidity on the Outcome of Angioplasty and Stenting.
Feng-Chi ChangChao-Bao LuoChih-Ping ChungKuei-Hong KuoTing-Yi ChenHan-Jui LeeChung-Jung LinJiing-Feng LirngWan-Yuo GuoPublished in: Scientific reports (2020)
Stenotic lesion rigidity (SLR) has an unclear influence on the outcome of percutaneous transluminal angioplasty and stenting (PTAS) for intracranial arterial stenosis. This study evaluated the outcome of PTAS and the relationship of vertebrobasilar SLR to features on vessel wall MRI (VW-MRI) for identifying pathologies of vertebrobasilar stenosis (VBS) and evaluating PTAS outcome. We retrospectively evaluated the results of PTAS in 31 patients with severe VBS. Stenotic lesions were classified as soft (based on predilatation pressure [PP] ≦ 4 atm) in 15 patients or hard (PP >4 atm) in 16 patients. We examined the relationship of SLR to clinical and MR findings. Patients with hard vs soft lesions had atherosclerosis (8/16 [50.0%] vs 2/15 [13.3%]), dissection (0/16 [0.0%] vs 12/15 [80.0%]), and dissection in atherosclerosis (8/16 [50.0%] vs 1/15 [6.7%], P < 0.0001); high intensity signal on the T1WI of VW-MRI (5/16 [31.3%] vs 14/15 [93.3%]) and iso- to low intensity signal (11/16 [68.7%] vs 1/15 [6.7], P = 0.001), and significant in-stent restenosis (>50%) in 5/15 (33.3%) vs 0/15 (0.0%) (P = 0.0421) in the 30 patients who successfully completed PTAS. Vertebrobasilar SLR correlated well with lesion etiology, findings on VW-MRI, and PTAS outcome. Patients with hard stenotic lesions need close follow-up after PTAS.
Keyphrases
- contrast enhanced
- end stage renal disease
- high intensity
- magnetic resonance imaging
- ejection fraction
- newly diagnosed
- chronic kidney disease
- peritoneal dialysis
- cardiovascular disease
- diffusion weighted imaging
- dna damage
- type diabetes
- oxidative stress
- early onset
- acute coronary syndrome
- coronary artery disease
- optical coherence tomography
- atrial fibrillation
- percutaneous coronary intervention
- resistance training
- patient reported
- body composition