Study on the correlation between the number and function of endothelial progenitor cells and in-stent restenosis after stent-implantation for symptomatic intracranial atherosclerotic stenosis

Objective To explore the relationship of endothelium progenitor cells(EPCs) number and function, the level of vascular endothelial growth factor (VEGF) with in-stent restenosis after stent implantation for symptomatic intracranial atherosclerotic stenosis. Methods From Jan 2008 to October 2012, a total of 87 patients stent-implantation with symptomatic intracranial atherosclerotic stenosis (sICAS) were prospectively studied in Liaocheng People′s Hospital. In 87 patients, there were 48 males and 39 females, the age was 48-81 years. All the patients were divided into restenosis group and non-restenosis group according to the examining results of Cranial CTA 1 year after percutaneous stent implantation. The EPCs number, adhesion and migration activities and the level of VEGF in the peripheral blood were tested and aralyzed in two groups. Results The 87 patients with symptomatic intracranial atherosclerotic stenosis were successfully performed percutaneous intravascular stent implantation, 23 patients showed varying degrees of in-stent restenosis 1 year after post-operatively, the restenosis rate of 14 patients was more than 50%. The number of endothelial progenitor cells [(36.5 ±4.8) /mL vs (65.6 ± 6.7) /mL], adhesion activities[(27.4 ± 7.3) /mL vs (58.5 ± 9.4) /mL], migration activities[(13.6±3.7) /mL vs (24.7±6.8) /mL] and level of VEGF[(57.79±13.53) pg/ mL vs (94.36±17.57) pg /mL]were significantly lower in restenosis group than non-restenosis group (t=19.110, 14.376, 7.425, and 9.051, respectively, all P values<0.05). Conclusions The risk of in-stent restenosis is increased in the patients which the migration ability of EPC, and the level of EPC and VEGF will decrease significantly 1 year after postoperatively. It is helpful to judge the possibility of in-stent restenosis and certain clinical values for long-term prognosis of patients to detect the level of EPCs and VEGF. It may offer a new way for prevention of in-stent restenosis after stenting by changing the levels of EPCs and VEGF. Key words: Intracranial arterial diseases; Atherosclerosis; Arteriarctia; Stents; Endothelium progenitor cells; Vascular endothelial growth factor