Background Percutaneous transluminal balloon angioplasty (PTBA) may be an alternative treatment for patients with symptomatic intracranial atherosclerotic disease (ICAD) refractory to medical treatment. This study aimed to investigate the association of vessel wall geometric characteristics on high-resolution magnetic resonance vessel wall imaging (MR-VWI) with low residual stenosis in patients with ICAD after PTBA.
Methods Patients with symptomatic ICAD who underwent PTBA were prospectively and consecutively enrolled. High-resolution MR-VWI was performed before the PTBA. Vessel wall geometries of the target artery, including normalized wall index (NWI: wall area/vessel area × 100%), normalized wall thickness index (NWTI: mean wall thickness/vessel radius × 100%), and remodeling index (RI) were evaluated. Low residual stenosis was defined as postprocedural stenosis degree ≤50%. Perioperative complications including symptomatic ischemic stroke/intracranial hemorrhage, death, and arterial dissection were recorded. The baseline characteristics, vessel wall geometries, and perioperative complications were compared between the patients with low residual stenosis and high residual stenosis.
Results Among 60 patients prospectively enrolled, low residual stenosis was achieved in 46 participants (77%). Three patients (5%) suffered from symptomatic ischemic stroke within 30 days. Multivariable logistic regression showed that a lower NWI and lower NWTI were associated with low residual stenosis after PTBA (adjusted OR 0.57, 95% CI 0.35 to 0.94, p=0.027; and adjusted OR 0.88, 95% CI 0.80 to 0.98, p=0.015).
Conclusions Lower NWI and NWTI of the target artery on high-resolution MR-VWI were associated with low residual stenosis in patients with ICAD after PTBA.
- vessel wall
Data availability statement
Data are available upon reasonable request.
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ZH and ZZ contributed equally.
Contributors ZKH, ZZ, JJ, NM: study concept and design, data analysis, drafting the manuscript, and full responsibility of data. LY, JDY, MW, JS: data collection. ZKH, JJ, XL: imaging data analysis. YSP: data analysis. FH: revising the manuscript. ZRM, XL, YJW: study concept and design of the work. All authors approved the final version to be published. They agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the manuscript are appropriately investigated and resolved.
Funding This study was supported by the National Natural Science Foundation of China (Contract grant number: 81471390 to NM, 81825012 and 81730048 to XL). Specialized in clinical medical development - 'Yangfan Plan' (XMLX201844 to NM).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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