Evaluation of Angiographic and Technical Aspects of Carotid Stenting with Diffusion-Weighted Magnetic Resonance Imaging

Journal Article · Wed Jul 15 00:00:00 EDT 2009 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-009-9526-6· OSTI ID:21428508

Blasel, Stella; Hattingen, Elke; Berkefeld, Joachim; Kurre, Wiebke ^[1]; Morawe, Gerald ^[2]; Zanella, Friedhelm

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1. University of Frankfurt, Institute of Neuroradiology (Germany)
2. University of Frankfurt, Department of Biomathematics (Germany)

The detection of clinically silent ischemic lesions on postprocedural diffusion-weighted magnetic resonance images has become a preferred method for the description of embolic risks. The purpose of this single-center study was to evaluate whether diffusion-weighted imaging (DWI) could determine material related or technical risk factors of filter-protected carotid stenting. Eighty-four patients with symptomatic severe ({>=}60%) carotid artery stenoses received filter-protected carotid stenting. Standard DWI (b = 1000) was performed within 48 h before and after carotid stenting. The occurrence and load of new postinterventional DWI lesions were assessed. Multivariate analysis was performed to determine risk factors associated with DWI lesions, with emphasis on technical factors such as use of different access devices (guiding catheter method vs. long carotid sheath method), type of stent (open-cell nitinol stent vs. closed-cell Wallstent), and protective device (filters with 80-{mu}m vs. 110-120-{mu}m pore size). Markers for generalized atherosclerosis and for degree and site of stenosis were assessed to allow comparison of adequate risk profiles. Access, protective device, and stent type were not significantly associated with new embolic DWI lesions when we compared patients with equivalent risk profiles (long carotid sheath method 48% [11 of 23] vs. guiding catheter method 44% [27 of 61], Wallstent 47% [15 of 32] vs. nitinol stent 44% [23 of 52], and small pore size filter 61% [11 of 18] vs. large pore size filter 41% [27 of 66]). Single-center DWI studies with a moderate number of cases are inadequate for proper assessment of the embolic risk of technical- or material-related risk factors in carotid stenting. Larger multicenter studies with more cases are needed.

• OSTI ID: 21428508
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 32, Issue 4; Other Information: DOI: 10.1007/s00270-009-9526-6; Copyright (c) 2009 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Article Copyright (c) 2009 Springer Science+Business Media, LLC; ISSN 0174-1551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIOSCLEROSIS
CAROTID ARTERIES
DIFFUSION
EMBOLI
FILTERS
HAZARDS
MULTIVARIATE ANALYSIS
NICKEL ALLOYS
NMR IMAGING
TITANIUM ALLOYS
TUBES
ALLOYS
ARTERIES
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
DIAGNOSTIC TECHNIQUES
DISEASES
MATHEMATICS
ORGANS
STATISTICS
TRANSITION ELEMENT ALLOYS
VASCULAR DISEASES