In-stent Restenosis After Stenting for Superior Mesenteric Artery Dissection Is Associated With Stent Landing Zone: From Clinical Prediction to Hemodynamic Mechanisms

医学 支架 再狭窄 优势比 心脏病学 血流动力学 内科学 肠系膜上动脉 放射科 外科
作者
Junhao Mei,Hui Yan,Xi Zhao,Yuan Yuan,Haobo Su,Tongqing Xue,Zhongzhi Jia
出处
期刊:Journal of Endovascular Therapy [SAGE Publishing]
被引量:1
标识
DOI:10.1177/15266028241241494
摘要

Objective: To identify risk factors for in-stent restenosis (ISR) in patients undergoing stent placement for superior mesenteric artery dissection (SMAD) and to determine the hemodynamic mechanism underlying ISR. Methods: For this retrospective study, patients with SMAD who had ISR after stent placement were included in the ISR group, and age- and sex-matched patients with SMAD who did not experience ISR after stent placement were included in the control group. Clinical, imaging, and hemodynamic data were assessed. Multivariable regression was used to identify independent ISR risk factors. Structural and fluid dynamics simulations were applied to determine the hemodynamic mechanism underlying the occurrence of ISR. Results: The study population included 26 patients with ISR and 26 control patients. Multivariate analysis demonstrated that stent-to-vascular (S/V) ratio (odds ratio [OR], 1.14; 95% confidence interval [CI]: 1.00–1.29; p=0.045), stent proximal position >10 mm away from the SMA root (OR, 108.67; 95% CI: 3.09–3816.42; p=0.010), and high oscillatory shear index (OSI) area (OR, 1.25; 95% CI: 1.02–1.52; p=0.029) were predictors of ISR. In structural and fluid dynamics simulations, a stent proximal position near the abdominal aorta (AA) or entering into the AA reduced the contact area between the proximal struts of the stent and the vascular wall, and alleviated the distal lumen overdilation. Conclusion: The S/V ratio, stent proximal position away from the SMA root (>10 mm), and high OSI area are independent risk factors for ISR in patients with SMAD undergoing stent placement. Deploying the proximal end of the stent near the AA or entering into the AA appears to improve the hemodynamic environment in the SMA lumen and ultimately reduce the risk of ISR. Clinical Impact In-stent restenosis is an uncommon but potentially catastrophic complication after stent placement for the management of superior mesenteric artery dissection. This study identified risk factors for in-stent restenosis and demonstrated that, as long as the stent can fully cover the dissection range, deploying the proximal end of the stent near the abdominal aorta or less entering into the abdominal aorta may reduce the risk of in-stent restenosis in this patient population.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
xn201120发布了新的文献求助10
1秒前
阳光凡儿完成签到,获得积分10
2秒前
爆米花应助公孙世往采纳,获得10
4秒前
5秒前
6秒前
7秒前
7秒前
乐乐应助健忘英姑采纳,获得10
9秒前
嗯嗯发布了新的文献求助10
9秒前
10秒前
Wangyicong完成签到,获得积分10
11秒前
Lucas应助科研通管家采纳,获得10
12秒前
萧水白应助科研通管家采纳,获得10
12秒前
Lucas应助科研通管家采纳,获得10
12秒前
田様应助科研通管家采纳,获得10
12秒前
大模型应助科研通管家采纳,获得10
12秒前
大模型应助科研通管家采纳,获得10
12秒前
bkagyin应助科研通管家采纳,获得30
12秒前
科研通AI2S应助科研通管家采纳,获得10
12秒前
FashionBoy应助科研通管家采纳,获得10
12秒前
12秒前
12秒前
萧水白应助科研通管家采纳,获得10
12秒前
12秒前
12秒前
12秒前
阿腾发布了新的文献求助10
13秒前
FloppyWow完成签到 ,获得积分10
14秒前
xn201120发布了新的文献求助150
14秒前
舒心的依风完成签到,获得积分10
15秒前
嗯嗯完成签到,获得积分10
16秒前
baba发布了新的文献求助10
17秒前
胡庆余堂小洋参完成签到,获得积分10
17秒前
Akim应助义气萝卜头采纳,获得10
19秒前
眼睛大寻双完成签到,获得积分20
20秒前
Orange应助兴奋雁蓉采纳,获得10
21秒前
猪猪hero应助ElbingX采纳,获得20
23秒前
24秒前
24秒前
25秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 700
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3976267
求助须知:如何正确求助?哪些是违规求助? 3520472
关于积分的说明 11203425
捐赠科研通 3257089
什么是DOI,文献DOI怎么找? 1798589
邀请新用户注册赠送积分活动 877785
科研通“疑难数据库(出版商)”最低求助积分说明 806523