Risk Early Warning Model and Prevention and Control Measures for Recurrence of Intracranial Anterior Circulation Atherosclerotic Stenosis Treated with LVIS Stent
LI Wenyan
LIU Zining
GUO Yuanyuan
LI Guanghui
LIU Yonggui
Abstract：Objective To analyze the risk factors for recurrence of symptomatic intracranial atherosclerosis stenosis(sICAS)after treatment with LVIS stent,establish a nomogram risk warning model,validate it using internal and external data,and explore prevention and control measures for postoperative recurrence.Methods A total of 297 patients with sICAS who were treated in the First Affiliated Hospital of Zhengzhou University from April 2020 to January 2024 were selected and all received LVIS stent treatment.The recurrence of patients within one year after surgery was analyzed,and they were divided into a recurrent group(40 cases)and an unrecurred group(257 cases)based on whether or not they had recurred.The clinical data of patients in the recurrence group and the non-recurrence group were compared,and the risk factors for postoperative recurrence were analyzed by unifactorial and multifactorial logistic regression,and the risk warning model of the column-line diagram was constructed,and the predictive value of the model was verified.Results The proportion of patients aged ≥ 60 years,the proportion of patients with a history of smoking,the proportion of patients with diabetes,the proportion of patients with hypertension,the proportion of patients with abnormal blood lipids,the proportion of patients with vascular stenosis ≥70％,the proportion of patients with stent length ≥ 30 mm,the proportion of patients with stent diameter＜4.5 mm,the proportion of patients with non-standardized medication use,and triglycerides(TG),high-sensitivity C-reactive protein(hs-CRP),lipoprotein(a)[LP(a)]were higher in the recurrent group than those in the non-recurrent group,and the differences were statistically significant(P＜0.05).The results of logistic regression analysis showed that age ≥ 60 years,diabetes,hypertension,dyslipidemia,stent length ≥30 mm,stent diameter＜4.5 mm,non-standardized medication,TG,and LP(a)were risk factors for LVIS stent recurrence in patients with sICAS after treatment.Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of the model was 0.921(95％CI:0.875-0.968).The calibration curve and decision curve showed that the model has high predictive performance and accuracy.Conclusion The risk factors for recurrence of patients with atherosclerotic stenosis of intracranial anterior circulation treated with LVIS stent are age≥60 years,diabetes,hypertension,dyslipidemia,stent length ≥ 30 mm,stent diameter＜4.5 mm,non-standard drug use,TG,LP(a).The nomogram risk early warning model based on the above risk factors has high prediction efficiency and accuracy,and can be targeted to formulate postoperative recurrence prevention and control measures to reduce the postoperative recurrence rate.
Keywords：intracranial atherosclerotic stenosisLVIS stent implantation surgerypostoperative recurrenceline chart warning modelmodel validationprevention and control measure
Publication Date：2025-04-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：7( 1205-1211 )