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

Blasel, Stella; Hattingen, Elke; Berkefeld, Joachim; Kurre, Wiebke; Morawe, Gerald; Zanella, Friedhelm

doi:10.1007/S00270-009-9526-6

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

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Abstract

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%more »« less

Authors:

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

University of Frankfurt, Institute of Neuroradiology (Germany)
University of Frankfurt, Department of Biomathematics (Germany)

Publication Date:: Wed Jul 15 00:00:00 EDT 2009

OSTI Identifier:: 21428508

Resource Type:: Journal Article

Journal Name:: Cardiovascular and Interventional Radiology

Additional Journal Information:: Journal Volume: 32; Journal 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; Journal ID: ISSN 0174-1551

Country of Publication:: United States

Language:: English

Subject:: 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

Citation Formats


                    Blasel, Stella, Hattingen, Elke, Berkefeld, Joachim, Kurre, Wiebke, Morawe, Gerald, Zanella, Friedhelm, and Rochemont, Richard Du Mesnil de. Evaluation of Angiographic and Technical Aspects of Carotid Stenting with Diffusion-Weighted Magnetic Resonance Imaging.  United States: N. p., 2009. 
        Web.  doi:10.1007/S00270-009-9526-6.

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                    Blasel, Stella, Hattingen, Elke, Berkefeld, Joachim, Kurre, Wiebke, Morawe, Gerald, Zanella, Friedhelm, & Rochemont, Richard Du Mesnil de. Evaluation of Angiographic and Technical Aspects of Carotid Stenting with Diffusion-Weighted Magnetic Resonance Imaging.  United States.  https://doi.org/10.1007/S00270-009-9526-6

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                    Blasel, Stella, Hattingen, Elke, Berkefeld, Joachim, Kurre, Wiebke, Morawe, Gerald, Zanella, Friedhelm, and Rochemont, Richard Du Mesnil de. 2009.  
        "Evaluation of Angiographic and Technical Aspects of Carotid Stenting with Diffusion-Weighted Magnetic Resonance Imaging".  United States.  https://doi.org/10.1007/S00270-009-9526-6.

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@article{osti_21428508,

  title        = {Evaluation of Angiographic and Technical Aspects of Carotid Stenting with Diffusion-Weighted Magnetic Resonance Imaging},

  author       = {Blasel, Stella and Hattingen, Elke and Berkefeld, Joachim and Kurre, Wiebke and Morawe, Gerald and Zanella, Friedhelm and Rochemont, Richard Du Mesnil de},

  abstractNote = {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.},

  doi          = {10.1007/S00270-009-9526-6},

  url          = {https://www.osti.gov/biblio/21428508},
  journal      = {Cardiovascular and Interventional Radiology},

  issn         = {0174-1551},

  number       = 4,

  volume       = 32,

  place        = {United States},

  year         = {Wed Jul 15 00:00:00 EDT 2009},

  month        = {Wed Jul 15 00:00:00 EDT 2009}

}

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