中国现代医学杂志2026，Vol.36Issue(9)：7-13,7.DOI:10.3969/j.issn.1005-8982.2026.09.002
术前超声斑块特征在评估颈动脉支架植入术后再狭窄风险中的价值
The value of preoperative ultrasound plaque characteristics in evaluating the risk of in-stent restenosis after carotid artery stent implantation
摘要
Abstract
Objective To analyze the value of preoperative ultrasound plaque characteristics in evaluating the risk of in-stent restenosis(ISR)after carotid artery stent implantation(CAS).Methods This study adopted a retrospective analysis method to collect clinical data of a total of 200 patients with carotid artery stenosis who underwent CAS treatment in our hospital.The selection period was from June 2022 to September 2024.According to whether ISR occurred during the follow-up period after CAS,all enrolled patients were divided into the ISR group(36 cases)and the non-ISR group(164 cases).The clinical data and ultrasound plaque characteristics of the ISR group and the non-ISR group were compared,and the influencing factors of ISR after CAS were analyzed.The receiver operating characteristic(ROC)curve was drawn to analyze the evaluation value of peak systolic velocity(PSV)at the stenosis site for the occurrence of ISR after CAS surgery.Results The comparison of hypertension prevalence between the ISR group and the non-ISR group showed a statistically significant difference,indicating that the hypertension prevalence in the ISR group was higher than that in the non-ISR group(P＜0.05).There were statistically significant differences in the composition ratios of plaque shape,echo nature,grade of new blood vessels within the plaque,and PSV at the stenosis site between the ISR group and the non-ISR group(P＜0.05).The composition ratio of irregular plaque shape,low echo nature of echo,grade ≥ 2 of new blood vessels within the plaque,and PSV value at the stenosis site in the ISR group were higher than those in the non-ISR group.Multivariate general Logistic regression analysis was conducted.The results showed that hypertension[(OR)=2.034(95％CI:1.085,3.813)],irregular plaques[(OR)=1.698(95％CI:1.145,2.518)],hypoechoic plaques[(OR)=1.625(95％CI:1.149,2.298)],plaque neovascularization grade ≥ 2[(OR)=2.231(95％CI:1.301,3.826)],and high PSV[(OR)=1.882(95％CI:1.254,2.825)]at the stenosis site were all risk factors for ISR after CAS(P＜0.05).The ROC curve analysis showed that the PSV value at the stenosis site had a sensitivity of 72.21％(95％CI:0.592,0.824)and a specificity of 75.62％(95％CI:0.641,0.899)for predicting ISR after CAS surgery,with an area under the curve of 0.788(95％CI:0.707,0.868).Conclusion Hypertension,irregular plaques,hypoechoic plaques,abundant neovascularization and elevated PSV at the stenosis site are closely related to the occurrence of ISR after CAS,and PSV at the stenosis site has good evaluation value.关键词
颈动脉支架植入术/支架内再狭窄/术前超声斑块特征/新生血管Key words
carotid artery stent implantation/in-stent restenosis/preoperative ultrasound plaque characteristics/new blood vessels分类
医药卫生引用本文复制引用
张语嫣,彭雯佳,邵成伟..术前超声斑块特征在评估颈动脉支架植入术后再狭窄风险中的价值[J].中国现代医学杂志,2026,36(9):7-13,7.基金项目
上海市自然科学基金(22ZR1478100) （22ZR1478100）
