Risk Factors Of In-stent Restenosis After Carotid Artery Stenting:A Meta-analysis

Objective: Carotid stenting is a safe and reliable surgical procedure for the treatment of carotid stenosis,but its long-term efficacy may be affected by the high restenosis rate(ISR)in the postoperative stent.Therefore,systematically evaluate and Find the risk factors that influence in-stent restenosis is particularly critical,and to provide a theoretical basis for guiding clinical prevention and treatment of in-stent restenosis after carotid stent implantation.Methods: Taking Chinese and English search terms of Carotid arteries Stent,restenosis,risk factors,etc,retrieving Case-controlled study or cohort study on the risk factors associated with stent restenosis following carotid stent implantation published during January 1,2000-December 31,2018 in PubMed,Embase,Cochrane Library and CNKI.The literature quality was evaluated by using Newcastle-Ottawa Scale(NOS)Document quality evaluation scale.Meta analysis was carried out using Revman 5.3 and Stata15 statistical software.Results: Through the retrieval of a total of 409 Chinese and English literature,excluding repetition and non-conformity into the standard literature,and finally included 13 case-control studies,a total of 2730 patients,including 243 patients with stent restenosis after carotid stent implantation and 2487 patients with no stent restenosis after carotid artery stent implantation.Meta analysis showed: The effect of hypertension(OR=2.05,95%CI:1.42-2.96,P =0.0001),postoperative restenosis of CEA(OR =4.23,95%CI:[1.93,9.26],P =0.0003),hyperlipidemia(OR=1.77,95%CI:1.32-2.38,P=0.0001),History of cerebral infarction(OR=2.94,95%CI:1.33-6.50,P=0.008)on restenosis after carotid stenting were statistically significant.Conclusion: Hypertension,hyperlipidemia,Post-CEA stenosis and cerebral infarction are the risk factors for stent restenosis after stent implantation of carotid artery stenosis,In clinical work,we should pay attention to the risk factors associated with stent restenosis,in the hope of reducing the incidence of in-stent restenosis.