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Ischemic stroke
Original research
Calcification is a risk factor for intracranial in-stent restenosis: an optical coherence tomography study
  1. Tianhua Li1,2,
  2. Ran Xu1,2,
  3. Yan Ma1,2,
  4. Tao Wang1,2,
  5. Bin Yang1,2,
  6. Liqun Jiao1,2,3
  1. 1 Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
  2. 2 China International Neuroscience Institute (China-INI), Beijing, China
  3. 3 Department of Interventional Neuroradiology, Xuanwu Hospital Capital Medical University, Beijing, China
  1. Correspondence to Dr Liqun Jiao; liqunjiao{at}sina.cn

Abstract

Background The frequent occurrence of calcification in intracranial artery stenosis increases the risk of ischemic stroke. In previous cases, we have observed a possible relationship between calcification and intracranial in-stent restenosis (ISR) using optical coherence tomography (OCT). Therefore, our study aimed to demonstrate the relationship between intracranial calcification and ISR with a larger sample size.

Methods For our study patients who underwent OCT for intracranial artery stenosis before stenting were included from May 2020 to October 2022. Follow-up assessments were performed using transcranial color-coded duplex (TCCD) sonography ultrasonography to detect cases of ISR.

Results We recruited 54 patients, 15 of them were excluded as they did not meet the study criteria. Our study included 39 patients, of whom 21 had calcification, and 18 did not. The results of our study revealed a significant association between calcification and intracranial ISR (9 (42.86) vs 2 (11.11), p=0.0375). Notably, patients with macrocalcification were more likely to undergo ISR than patients with spotty calcification (77.78% vs 22.22%, p=0.03).

Conclusion OCT imaging demonstrates that calcification is an essential risk factor for intracranial ISR. These findings have important implications for individualized treatment. They provide valuable insights for optimizing stent design and exploring potential mechanisms of intracranial ISR.

Trial registration number ClinicalTrials.gov Identifier: NCT05550077.

  • Plaque
  • Stenosis
  • Stent
  • Stroke
  • Atherosclerosis

Data availability statement

Data are available upon reasonable request. The data used to support the findings of this study are available from the corresponding author upon request.

https://doi.org/10.1136/jnis-2023-020624

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    Data availability statement

    Data are available upon reasonable request. The data used to support the findings of this study are available from the corresponding author upon request.

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    Footnotes

    • TL and RX are joint first authors.

    • Contributors LJ, BY, YM, TL, RX: study design, acquired and analyzed the data, statistical analysis, and manuscript drafting. TL, TW: acquired and analyzed the data. TL, RX: data collection. RX, TW: revised the draft paper. BY, LJ: study design and revision of manuscript. LJ is responsible for the overall content as the guarantor.

    • Funding This study was supported by Beijing Hospitals Authority’s Ascent Plan (DFL20220702) and Research and translation application of clinical diagnosis and treatment technology of the capital (Z201100005520020; Z201100005520019).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.