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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
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Effect of Angiographic Hemodynamic Parameters and Vascular Tortuosity on In-Stent Restenosis in Intracranial

Yangyang Jiang1, Weihe Yao2, Juan Du2

  • 1Department of Neurology, Nanjing Jinling Hospital Affiliated to Nanjing Medical University, Nanjing, China.

Clinical Neuroradiology
|January 29, 2026
PubMed

Insights

In-stent restenosis (ISR) after stenting for intracranial atherosclerotic stenosis (ICAS) is linked to residual stenosis, high MHR, hyperglycemia, and specific vascular features. A predictive model incorporating these factors shows strong potential for identifying high-risk patients.

Area of Science:

  • Neurology
  • Cardiology
  • Medical Imaging

Background:

  • In-stent restenosis (ISR) is a key limitation impacting the long-term success of stenting procedures for intracranial atherosclerotic stenosis (ICAS).
  • Understanding the risk factors for ISR is crucial for improving patient outcomes and optimizing treatment strategies.

Purpose of the Study:

  • To identify clinical, angiographic hemodynamic, and vascular morphological risk factors associated with ISR in patients with ICAS undergoing stenting.
  • To develop and validate a predictive model for ISR in this patient population.

Main Methods:

  • Retrospective analysis of patients with severe symptomatic ICAS who underwent stenting.
  • Assessment of vascular morphology (angle, relative length [RL], triangulation index [TI]) and hemodynamic parameters (relative time to peak [rTTP]) using quantitative digital subtraction angiography.
  • Logistic regression analysis to determine significant risk factors for ISR, followed by the development of a predictive model.

Main Results:

  • Of 106 included patients, 20.8% developed ISR within a median follow-up of 6.6 months.
  • Multivariate analysis identified residual stenosis, monocyte to high-density lipoprotein cholesterol ratio (MHR), hyperglycemia, post-stenting RL, and trans-stenotic rTTP difference as significant predictors of ISR.
  • The developed predictive model demonstrated strong predictive capability with an AUC of 0.867.

Conclusions:

  • Angiographic hemodynamic parameters, vascular tortuosity, and MHR are significant indicators of ISR risk.
  • The developed predictive model shows promise for effectively identifying patients at high risk of developing ISR after stenting for ICAS.
Abstract

Keywords:
HemodynamicsIn-stent restenosisIntracranial atherosclerosisMonocyte to high-density lipoprotein cholesterol ratioMorphology

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