Risk factors of in⁃stent restenosis for intracranial artery stenosis: a Meta⁃analysis

Abstract

Objective To assess the risk factors of in-stent restenosis (ISR) for intracranial artery stenosis by Meta-analysis. Methods Retrieve relevant case-control studies or cohort studies from online databases (January 1, 1990-August 1, 2017) as PubMed, EBMASE/SCOPUS and Cochrane Library with key words: intracranial artery, stent, restenosis, risk factors, predictors. Selection of studies was performed according to pre-designed inclusion and exclusion criteria. Quality of studies was evaluated by using Newcastle-Ottawa Scale (NOS). All data were pooled by RevMan 5.3 software for Meta-analysis. Results The research enrolled 305 articles, from which 16 high-quality (NOS score>=6) studies were chosen after excluding duplicates and those not meeting the inclusion criteria. A total of 1102 cases (ISR:N =245; non-ISR: N=857) were included. Meta-analysis showed that diabetes (OR=1.880, 95%CI:1.290-2.740; P=0.001), lesions stenosis length>10 mm (OR=3.550, 95%CI:1.160-10.850; P=0.030), anterior circulation lesions (OR=1.680, 95%CI:1.170-2.420; P=0.005), postoperative residual stenosis>=30% (OR=3.290, 95%CI:1.460-7.410; P=0.004) and bare metal stents (OR=4.290, 95%CI:1.130-16.260; P=0.030) increased the risk of ISR significantly. Conclusions Diabetes, lesions stenosis length>10 mm, anterior circulation lesions, postoperative residual stenosis>=30% and bare metal stents were risk factors of in-stent restenosis. Clinicians should avoid related risk factors and reduce the occurrence of in-stent restenosis.