Progress of Intracranial In-stent Restenosis

doi:10.3969/j.issn.1673-5765.2021.06.018

Abstract

Abstract: In-stent restenosis (ISR) is a major complication of stent implantation for symptomatic intracranial atherosclerotic stenosis (ICAS) or occlusion, which is closely related to long-term recurrent stroke. The pathophysiological mechanism of ISR is still unclear, but it may be related to intimal hyperplasia after arterial injury, and inflammation plays a crucial role in development of ISR. Risk factors for intracranial ISR include lesion location, diabetes, stent diameter, rapid balloon dilatation and long lesion. Currently, target lesion revascularization is the main therapy for intracranial ISR, including simple balloon dilation, metal stent implantation, drugcoated balloon dilation and drug-eluting stent implantation. Drug-coated balloon is expected to be the main measures to prevent intracranial ISR. Preprocedural identification of high-risk ISR can provide a basis for the device selection for endovascular therapy in ICAS patients.

Key words: Symptomatic intracranial atherosclerotic stenosis; Stent; In-stent restenosis

摘要： 支架内再狭窄（i n-stent restenosis，ISR）是支架治疗症状性颅内动脉粥样硬化性狭窄（intracranial atherosclerotic stenosis，ICAS）/闭塞患者的主要并发症，与晚期卒中复发密切相关。颅内 ISR发生的病理生理机制尚不清楚，但目前认为与动脉损伤后内膜增生密切相关，炎症在其中起到至关重要的作用。ISR的危险因素包括血管狭窄部位、糖尿病、支架直径、快速球囊扩张及长病变等。目前靶血管血运重建是治疗ISR的主要方法，包括单纯球囊扩张、金属支架植入、药物涂层球囊及药物洗脱支架。药物涂层球囊有望成为预防颅内ISR的主要方法，术前识别高危ISR患者可为ICAS患者血管内治疗设备的选择提供依据。

关键词: 颅内动脉粥样硬化性狭窄; 支架; 支架内再狭窄

YU Ying, LOU Ya-Ke, CUI Rong-Rong, JIANG Ling-Xian, MA Ning. Progress of Intracranial In-stent Restenosis[J]. Chinese Journal of Stroke, 2021, 16(06): 619-624.

余莹, 娄亚柯, 崔荣荣, 姜玲先, 马宁. 颅内动脉支架内再狭窄的研究进展[J]. 中国卒中杂志, 2021, 16(06): 619-624.

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