The predictive factors for in-stent restenosis after interventional treatment of chronic carotid artery occlusion

Background In-stent restenosis (ISR) is a potential severe complication that occurs in patients with severe carotid artery narrowing after carotid angioplasty and stent placement. However, this phenomenon has not been fully studied in the context of interventional treatment for chronic internal carotid artery occlusion (CICAO). Purpose To quantify the ISR rate and identify the risk factors leading to this event. Material and Methods This study included 69 patients with symptomatic CICAO who underwent successful intravascular recanalization at our institution. Clinical information, outcomes, and prognosis of the patients were recorded. The related factors of ISR were analyzed through univariate and multivariate analysis. Results A total of 11 (15.9%) patients developed a significant ISR > 70% during the follow-up period. Among them, five patients with ISR experienced symptomatic restenosis. Our study found hyperlipidemia ( P = 0.017), contralateral internal carotid artery occlusion ( P = 0.041), and prolonged radiologic occlusion to recanalization time ( P = 0.049) could contribute to the risk of ISR in patients with CICAO. Conclusion ISR is not rare in patients with CICAO after successful intervention. Hyperlipidemia, contralateral ICA occlusion, and prolonged radiologic occlusion to recanalization time are the risk factors for ISR after treatment in patients with CICAO.