Incidence and Risk Factors of In-Stent Restenosis for Symptomatic Intracranial Atherosclerotic Stenosis: A Systematic Review and Meta-Analysis
Guangge Peng, Yupeng Zhang, Zhongrong Miao
Abstract
BACKGROUND: In-stent restenosis affects long-term outcome in patients with intracranial atherosclerotic stenosis. PURPOSE: The aim of this meta-analysis was to evaluate the incidence and risk factors of in-stent restenosis. DATA SOURCES: All literature that reported in-stent restenosis was searched on PubMed, Ovid EMBASE and Ovid MEDLINE data bases. STUDY SELECTION: Original articles about stents for symptomatic intracranial atherosclerotic stenosis were selected. DATA ANALYSIS: Meta-analysis was conducted to derive the pooled in-stent restenosis using a random-effects model. Meta-regression was performed to explore the risk factors predisposing to in-stent restenosis. DATA SYNTHESIS: = .018) were 2 independent risk factors for symptomatic in-stent restenosis rate. LIMITATIONS: The heterogeneity of most outcomes was high. CONCLUSIONS: Our study showed promising results of in-stent restenosis for symptomatic atherosclerotic stenosis. Studies are needed to further expatiate on the mechanisms by which younger patient age, vertebrobasilar junction location, and low residual stenosis could increase in-stent restenosis and symptomatic in-stent restenosis, respectively.