Risk factors of restenosis after paclitaxel-coated balloon treatment in symptomatic intracranial atherosclerotic disease

Paclitaxel-coated balloon (PCB) treatment has shown promise for intracranial atherosclerotic disease (ICAD). However, studies on restenosis and its associated factors after PCB use are lacking. This study aimed to elucidate risk factors of restenosis after PCB treatment for ICAD. We retrospectively enrolled consecutive patients who had been successfully treated with PCBs for symptomatic ICAD between January 2016 and December 2022. Eligible patients were classified into "no-restenosis" and "restenosis" groups by follow-up DSA. Demographic, clinical, laboratory test, and angiographic data were analyzed. Multivariate logistic regression analysis was used to explore the risk factors of restenosis after PCB treatment. A total of 261 eligible patients were enrolled in this study. There was no death and there were 6.51% (17/261) patients had ipsilateral stroke within 30 days. During 6 months clinical follow up, there was no death and there were 3.07% (8/261) patients had ipsilateral stroke after 30 days, and 13.41% (35/261) patients were identified with restenosis. The restenosis group had significantly higher follow-up hs-CRP (P = 0.040), higher stenosis degree (P = 0.011), higher total occlusion rate (P = 0.009), longer lesion length (P < 0.001), higher residual stenosis after intervention (P < 0.001) and lower stenting rate (P = 0.017).Multivariate logistic regression analysis showed that baseline neutrophil count (OR 1.356, 95% CI 1.015-1.812; P = 0.039), lesion length (OR 1.113, 95% CI 1.032-1.199; P = 0.005) and residual stenosis after intervention (OR 1.066, 95% CI 1.036-1.097; P < 0.001) were risk factors of restenosis.