You are here

  • Home
  • Online First
  • Plaque characteristics associated with failure of primary balloon angioplasty for intracranial atherosclerotic stenosis: a retrospective study

Article Text

Article menu
Download PDFPDF
Neuroimaging
Original research
Plaque characteristics associated with failure of primary balloon angioplasty for intracranial atherosclerotic stenosis: a retrospective study
  1. Yuexin Mei1,
  2. Shan Yu1,
  3. Zhuhao Li2,
  4. Hongbing Chen1,
  5. Jian Zhang1,
  6. Shuangquan Tan1,
  7. Jinsheng Zeng1,
  8. Shihui Xing1,
  9. Xinran Chen1
  1. 1Neurology, Sun Yat-sen University First Affiliated Hospital, Guangzhou, Guangdong, China
  2. 2Radiology, Sun Yat-sen University First Affiliated Hospital, Guangzhou, Guangdong, China
  1. Correspondence to Dr Xinran Chen, Neurology, Sun Yat-sen University First Affiliated Hospital, Guangzhou, Guangdong, 510080, China; chxran{at}mail2.sysu.edu.cn; Dr Shihui Xing, Department of Neurology, The First Affiliated Hospital, Sun Yat-Sen University; Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases; National Key Clinical Department and Key Discipline of Neurology, Guangzhou, Guangdong, 510080, China; xingshih{at}mail.sysu.edu.cn

Abstract

Background Primary balloon angioplasty (PBA) is an alternative treatment approach for intracranial atherosclerotic stenosis (ICAS); however, its efficacy may be compromised by arterial dissection or early elastic recoil after balloon dilation. This study aimed to explore the association between plaque characteristics on high-resolution magnetic resonance vessel wall imaging (HR-VWI) and failure of PBA for ICAS.

Methods We conducted a retrospective analysis of 113 patients with ICAS who underwent HR-VWI before endovascular treatment. Based on the presence of arterial dissection or early elastic recoil post-balloon dilation, patients were classified into the failed PBA (FPBA) group or the successful PBA (SPBA) group. Clinical and baseline HR-VWI characteristics were compared between the two groups. Multivariable analysis was used to investigate plaque features associated with the failure of PBA.

Results The FPBA and SPBA groups comprised 74 and 39 patients, respectively. Plaque eccentricity (83.78% vs 46.15%, P<0.001), negative remodeling (90.54% vs 48.72%, P<0.001), remodeling index (median 0.73 vs 0.90, P=0.001), and intraplaque hemorrhage (31.08% vs 5.13%, P=0.002) differed significantly between the FPBA and SPBA groups. Multivariable analysis indicated that higher frequency of plaque eccentricity (OR 14.03, 95% CI 3.42 to 57.62, P<0.001) and negative remodeling (OR 6.11, 95% CI 1.22 to 30.71, P=0.028) were independently associated with failure of PBA.

Conclusion Our findings showed that failure of PBA was associated with plaque eccentricity and negative remodeling. Analysis of plaque characteristics on baseline HR-VWI holds potential value for identifying arterial dissection or early elastic recoil after angioplasty in patients with ICAS.

  • Plaque
  • Vessel Wall
  • MRI
  • Balloon
  • Atherosclerosis

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/jnis-2023-021295

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    Data are available upon reasonable request.

    View Full Text

    Footnotes

    • Contributors XC, YM: study design and manuscript drafting. YM, SY, ZL: data collection and analysis, statistical analysis. JZ, ST, JZ: study design. XC, SX: revision of manuscript. HC, SX: endovascular treatment performance. XC is responsible for the overall content as the guarantor.

    • Funding This study was supported by grants from National Natural Science Foundation of China (81801059), Guangdong Provincial Clinical Research Center for Neurological Diseases (2020B1111170002), Guangdong Province International Cooperation Base for Early Intervention and Functional Rehabilitation of Neurological Diseases (2020A0505020004), Guangdong Provincial Engineering Center for Major Neurological Disease Treatment, Guangdong Provincial Translational Medicine Innovation Platform for Diagnosis and Treatment of Major Neurological Disease, Guangzhou Clinical Research and Translational Center for Major Neurological Diseases.

    • 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.