Analysis of risk factors for carotid artery restenosis after interventional therapy in patients with ischemic stroke

Xu Dan; Yang Zhanhui; Wang Peng; Zhang Aijun; Ji Hui

doi:10.3760/j.issn.1673-4777.2024.09.013

Abstract：Objective To analyze the risk factors of carotid artery restenosis after interventional therapy in patients with ischemic stroke.Methods The clinical data of 110 patients with ischemic stroke who underwent endovascular interventional therapy in Hengshui People's Hospital,Hebei Province from December 2020 to December 2022 were collected and retrospectively analyzed.All patients were followed up for 1 year.According to the results of re-examination of carotid ultrasound,the patients were divided into the non-restenosis group(42 cases)and the restenosis group(68 cases).Logistic regression was used to analyze the risk factors of carotid artery restenosis af-ter endovascular intervention in patients with ischemic stroke.The nomogram prediction model was constructed by R software,internal validation was performed by Bootstrap method,goodness of fit test was performed by Hosmer-Lemeshow test,and the predictive efficacy of the nomogram was evaluated by receiver operating characteristic(ROC)curve.Results The proportion of smoking history,hyperhomocysteinemia(HHcy),postoperative proximal carotid artery diameter＜6.8 mm,postoperative proximal internal carotid artery diameter＜4.8 mm,and postoper-ative serum C-reactive protein(CRP)＞10 mg/L in the restenosis group were higher than those in the non-restenosis group(all P＜0.05).The results of univariate Logistic regression analysis showed that smoking history,HHcy,small postoperative proximal diameter of the common carotid artery,small postoperative proximal diameter of the internal carotid artery,and high postoperative serum CRP were all risk factors for carotid artery restenosis after intravascular intervention(odds ratios=4 158.246,31.064,140.768,295.064,and 8 286.344,all P＜0.05).The nomogram prediction model and calibration curve based on the incidence of carotid restenosis after endovascular intervention had a good consistency with the actual incidence,and the concordance index was 0.913.The ROC curve analysis showed that the area under the curve was 0.913(95％confidence interval:0.821-0.942),indicating that the prediction model had high discrimination power and predictive value.Conclusion The occurrence of carotid artery restenosis after endovascular intervention in patients with ischemic stroke is related to smoking history,HHcy,small postoperative proximal diameter of common carotid artery,small postoperative proximal diameter of internal carotid artery,and high postoperative serum CRP,which should be paid attention to in clinical practice.