Peri-therapeutic multi-modal hemodynamic assessment and detection of predictors for symptomatic in-stent restenosis after percutaneous transluminal angioplasty and stenting

• DOI: 10.3389/fneur.2023.1136847
• Publication Date: 2023-04-18T04:49:21Z
• Authors: Xiaowen Song; Hancheng Qiu; Shuo Yang; Yuqi Liu; Yong Cao; Shuo Wang; Jizong Zhao
• Keywords: Neurology; percutaneous transluminal angioplasty and stenting; quantitative digital subtraction angiography; computational fluid dynamics; Neurology. Diseases of the nervous system; intracranial artery stenosis; RC346-429; 3. Good health; multi-modal hemodynamic

This study performed multi-modal hemodynamic analysis including quantitative color-coded digital subtraction angiography (QDSA) and computational fluid dynamics (CFD) to delineate peri-therapeutic changes explore the risk factors for in-stent restenosis (ISR) symptomatic ISR (sISR).Forty patients were retrospectively reviewed. Time peak (TTP), full width at half maximum (FWHM), cerebral circulation time (CCT), angiographic mean transit (aMTT), arterial stenosis index (ASI), wash-in gradient (WI), wash-out (WO) stasis calculated with QDSA translesional pressure ratio (PR) wall shear stress (WSSR) quantified from CFD analysis. These parameters compared between before after stent deployment multivariate logistic regression model was established detect predictors sISR follow-up.It found that stenting generally reduced TTP, index, CCT, aMTT WSSR while significantly increased PR. ASI decreased stenting, during follow-up of 6.48 ± 2.86 months, lower (<0.636) as well larger corroborated be independently associated sISR. showed a linear correlation CCT stenting.PTAS not only improved blood flow perfusion but also changed local hemodynamics significantly. derived proved play prominent role in stratification Multi-modal could facilitate intraoperative real-time monitoring help determination end point intervention.