{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T17:56:32Z","timestamp":1784829392668,"version":"3.55.0"},"reference-count":28,"publisher":"BMJ","issue":"6","funder":[{"name":"Beijing Municipal Administration of Hospitals\u2019 Youth Programme"},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2018,9,23]]},"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The study was designed to investigate if vascular occlusion in the internal carotid artery (ICA) or the contralateral vertebral artery (VA) contribute to developing in-stent restenosis (ISR) in patients with vertebral artery ostium stenosis (VAOS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>420 consecutive patients treated with VAOS stents (from a population of 8145 patients with VAOS) from January 2013 to December 2014 were analyzed in this retrospective study; 216 with drug eluted stents and 204 with bare metal stents. Based on pre-stent DSA findings, patients were divided into four groups: both carotid and vertebral arteries patent (PAT), ICA occlusion (ICA-OCC), contralateral VA occlusion (CVA-OCC), and combined occlusions (C-OCC). The incidence of ISR (stenosis &gt;50%) was compared between groups using Cox regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 420 patients, the mean incidence of ISR was 36.4%, with a median 12 months of follow-up (IQR 3\u201312). Logistic regression analysis showed that drug eluting stent had less ISR than bare metal stent (OR=0.38, 95%\u2009CI 0.19 to 0.75, P=0.01). Cox regression analysis showed that CVA-OCC (HR=1.63, P=0.02) and C-OCC (HR=3.30, P=0.001) were risk factors for ISR but not ICA-OCC (P=0.31). In the CVA-OCC and C-OCC groups, in-stent peak systolic velocity (PSV) \u2265140 cm\/s, 1\u2009day after successful stenting, was associated with subsequent development of ISR (OR=2.81, 95%\u2009CI 1.06 to 7.43, P=0.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Contralateral VA occlusion at the time of stenting increased the risk of ISR, especially if stent PSV on day 1 was &gt;140 cm\/s. Bare metal stents had more ISR than drug eluting stents.<\/jats:p><\/jats:sec>","DOI":"10.1136\/neurintsurg-2018-014243","type":"journal-article","created":{"date-parts":[[2018,10,19]],"date-time":"2018-10-19T12:47:39Z","timestamp":1539953259000},"page":"574-578","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Arterial occlusions increase the risk of in-stent restenosis after vertebral artery ostium 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