Relationships among Neutrophil-to-Lymphocyte Ratio, Serum Albumin Level, and Platelet-to-Lymphocyte Ratio with In-stent Restenosis in Cerebrovascular Bare-Metal Stenting

Background: In-stent restenosis (ISR) remains a serious clinical problem that affects the efficacy of endovascular treatment. Inflammation and platelet activation play an important role in the development of ISR after cerebrovascular bare-metal stenting. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), which are the indicators of inflammation, have been associated with stent restenosis, while low serum albumin (ALB) level has been associated with the adverse outcomes of cardiovascular diseases. We therefore explored the associations among preprocedural NLR, ALB level, and PLR with ISR after cerebrovascular bare-metal stenting and then investigated the value of preprocedural NLR, ALB level, and PLR for the development of ISR. Methods: : In this study, we enrolled 223 patients who underwent cerebrovascular bare-metal stenting (both intracranial and extracranial) and retrospectively analyzed their clinical, hematological, and angiographic data. Radiographic evaluations were performed at 6 and 12 months after the procedure. Results: : ISR was defined as ≥ 50% stenosis of the treated lesion. Patients were divided into two groups based on the occurrence of ISR. ISR occurred in 89 (39.91%) of the 223 included patients. Increased pre-procedural NLR ( p < 0.001) and PLR ( p < 0.001) and decreased pre-procedural ALB level ( p < 0.001) were significantly associated with ISR. Conclusions: : High pre-procedural NLR and PLR, and low pre-procedural ALB level may be used as predictors of ISR after cerebrovascular bare-metal stenting. Trial Registration: retrospective registration.