Peri-therapeutic multi-modal hemodynamic assessment and detection of predictors for symptomatic in-stent restenosis after percutaneous transluminal angioplasty and stenting
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Le résumé fourni par la source
Backgrounds: This study performed multi-modal hemodynamic analysis including quantitative color-coded digital subtraction angiography (QDSA) and computational fluid dynamics (CFD) to delineate peri-therapeutic hemodynamic changes and explore the risk factors for in-stent restenosis (ISR) and symptomatic ISR (sISR). Methods: Forty patients were retrospectively reviewed. Time to peak (TTP), full width at half maximum (FWHM), cerebral circulation time (CCT), angiographic mean transit time (aMTT), arterial stenosis index (ASI), wash-in gradient (WI), wash-out gradient (WO) and stasis index were calculated with QDSA and translesional pressure ratio (PR) and wall shear stress ratio (WSSR) were quantified from CFD analysis. These hemodynamic parameters were compared between before and after stent deployment and multivariate logistic regression model was established to detect predictors for ISR and sISR at follow-up. Results: It was found that stenting generally reduced TTP, stasis index, CCT, aMTT and translesional WSSR while significantly increased translesional PR. ASI decreased after stenting, and during the mean follow-up time of 6.48 ± 2.86 months, lower ASI (<0.636) as well as larger stasis index were corroborated to be independently associated with sISR. aMTT showed a linear correlation with CCT before and after stenting. Conclusion: PTAS not only improved cerebral circulation and blood flow perfusion but also changed local hemodynamics significantly. ASI and stasis index derived from QDSA were proved to play a prominent role in risk stratification for sISR. Multi-modal hemodynamic analysis could facilitate intraoperative real-time hemodynamic monitoring and help the determination of the end point of intervention.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Peri-therapeutic multi-modal hemodynamic assessment and detection of predictors for symptomatic in-stent restenosis after percutaneous transluminal angioplasty and stenting
- Date Crossref
- 18/04/2023
- Éditeur
- Frontiers Media SA
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Capital Medical University Department of Neurosurgery pays non établi dans la noticeUniversité ou école supérieure
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Beijing Tian Tan Hospital pays non établi dans la noticeÉtablissement de santé
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National Clinical Research Center for Digestive Diseases pays non établi dans la noticeÉtablissement de santé
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China National Clinical Research Center for Neurological Diseases pays non établi dans la noticeStructure de recherche
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New Era Stroke Care and Research Institute Department of Vascular Neurosurgery pays non établi dans la noticeStructure de recherche
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Escope Innovation Academy pays non établi dans la noticeInstitution
Department of Neurosurgery — Capital Medical University, Beijing Tian Tan Hospital et National Clinical Research Center for Digestive Diseases, avec 3 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.