Exploration of the Influencing Factors and Prognosis of the In-Stent Reocclusion of Patients with Anterior Circulation Tandem Lesions after Carotid Artery Stenting during Emergency Treatment
Objective To explore the possible influencing factors and prognosis of in-stent reocclusion of patients with anterior circulation tandem lesions after carotid artery stenting.Methods Retrospective continuous collection of the clinical data of patients with anterior circulation tandem lesions who underwent carotid artery stenting at Linyi People's Hospital from June 2020 to September 2022,and analysis of surgical procedures,vascular recanalization,postoperative complications,and prognosis of these patients were performed in this study.Based on the 90-day functional outcome,patients were categorized into favorable and unfavorable prognosis groups,and multivariate logistic regression analysis was employed to identify independent risk factors influencing patient prognosis.Results This study included 111 patients with anterior circulation tandem lesions who received carotid artery stenting during emergency treatment.Postoperatively,16(14.4％)patients experienced in-stent reocclusion.Analysis displayed that patients with in-stent reocclusion had a higher degree of residual stenosis after surgery,and most patients did not receive sufficient antithrombotic therapy before surgery.Based on the 90-day functional prognosis,111 patients were divided into a good prognosis group(66 cases)and a poor prognosis group(45 cases).Multivariate logistic regression analysis showed that postoperative in-stent reocclusion(OR 0.315,95％CI 0.106-0.932,P=0.037)and preoperative infarct core volume(OR 0.978,95％CI 0.959-0.997,P=0.023)were independent risk factors influencing the prognosis of patients.Conclusions Reocclusion after carotid artery stenting in patients with anterior circulation tandem lesions may be related to factors such as a high degree of postoperative residual stenosis and insufficient preoperative antithrombotic therapy.Preoperative infarct core volume and in-stent reocclusion are independent risk factors influencing the prognosis of patients.
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