Endothelial repairing function in patients with symptomatic middle cerebral arterial stenosis after stent implantation

Objective To investigate the relation between endothelial repairing function and in-stent restenosis in patients with symptomatic middle cerebral arterial (MCA) stenosis after stent implantation. Method Sixty-six patients with symptomatic MCA stenosis underwent percutaneous stent implantation. Cranial CTA revealed that 23 patients had MCA restenosis (restenosis group) 1 year after stenting, including 14 cases with >50% stenosis and 1 case with MCA occlusion, and 43 patients had no restenosis (non-restenosis group). The number of endothelial progenitor cells (EPC) was examined by flow cytometry, the adhesion function of EPC was tested by adhesion assay, the migration ability of EPC was tested by Transwell method and serum vascular endothelial growth factor(VEGF) levels were measured by ELISA. The relationship of endothelial repairing function with restenosis was analyzed. Results The MCA stent implantations were successfully performed in all patients. The EPC number (33.7±4.6 vs. 61.6± 6.4), adhesion activities (26.1±7.5 vs. 56.3±9.6), migration activities (12.0±3.9 vs. 21.4±6.5) and serum VEGF level [(56.7±14.6) vs. (89.6±17.32) ng/L] in restenosis group were significantly lower than those in non-restenosis group (t=18.48, 13.09, 6.34 and 7.73, all P<0.05). Conclusion For patients with MCA stenosis after percutaneous stent implantation the increased risk of in-stent restenosis is associated with low level of EPCs and their migration ability, and low serum VEGF level. Key words: Middle cerebral artery; Stent; Stem cells, endothelial cells; Vascular endothelial growth factors; Constriction, pathologic