Article Figures & Data
Figures
- Fig 1.
Case of a 65-year-old man with symptomatic moderate stenosis (49%) of the left carotid bifurcation.
A–C, Pre-CEA angiogram (A), pre-CEA DW image (B), and post-CEA DW image. Post-CEA DW image demonstrates a single, new, small hyperintensity (arrow) in the left striatocapsule near the small old lacune. This lesion was silent.
- Fig 2.
Case of a 68-year-old man with severe stenosis (91%) of the right ICA, who claimed severe unilateral headache after the third post-CEA day.
A–D, Pre-CEA angiogram (A), post-CEA T2-weighted MR image (B), post-CEA DW image (C), and post-CEA gradient-echo MR image (D). Post-CEA MR images show severe vasogenic edema with focal hemorrhage (arrow) in the right cerebral hemisphere.
- Fig 3.
Case of a 58-year-old man with symptomatic moderate stenosis (69%) of the right ICA.
A–D, Pre-CAS angiogram (A), pre-CAS DW image (B), post-CAS angiogram (C), post-CAS DW image (D). Post-CAS DW image demonstrates several small hyperintensities in the right cerebral hemisphere including the striatocapsule. Mild left-sided weakness and visual field defect occurred after CAS.
Tables
Characteristic CEA Procedures (n = 26) CAS Procedures (n = 22) Age (y), mean (range) 64.9 (48–77) 61.5 (37–80) Sex, no (%) Male 22 (92)* 20 (100)* Female 2 (8) 0 (0) Presenting symptom, no. (%) Transient ischemic attack and/or amaurosis fugax 5 (19) 3 (14) Cerebral and/or retinal infarction 14 (54) 15 (68) Asymptomatic 7 (27) 4 (18) Pretreatment carotid artery Ipsilateral stenosis, no. (%) Mean percentage stenosis ± SD 77.9 ± 13.2 76.3 ± 14.0 Moderate (40–70%) 7 (27) 8 (36) Severe (>70%) 19 (73) 14 (64) Ipsilateral plaque ulceration, no. (%) 21 (80) 18 (82) Contralateral stenosis, no. (%) Mean percentage stenosis ± SD 20.4 ± 30.5 59.2 ± 42.1 None or <20% stenosis 17 (62) 6 (27) Mild (20–40%) 4 (15) 1 (4) Moderate (40–70%) 3 (12) 3 (14) Severe (>70%) 2 (8) 4 (18) Occlusion 1 (4) 8 (36) * Two patients underwent bilateral CEA and two patients underwent bilateral CAS.
Posttreatment Result CEA (n = 26) CAS (n = 22) Unchanged DW image 25 (96) 14 (64) New hyperintensity on DW image 1 (4) 8 (36) Symptomatic hyperintensity on DW image 0 of 1 (0) 2 of 8 (25) Neurological and/or visual deficit 1 (4) 3 (14) Nonischemic complication 5 (19) 0 (0) Total symptomatic complications 5 (19) 3 (14) Note.—Data are number (%) of procedures.
Angiographic Variables CEA (n = 26) CAS (n = 22) Ipsilateral ICA stenosis Severe 0 (0 of 19) 29 (4 of 14) Moderate 1 (1 of 7) 50 (4 of 8) Contralateral ICA stenosis Occlusion or severe 33 (1 of 3) 33 (4 of 12) Normal to moderate 0 (0 of 23) 40 (4 of 10) Ipsilateral ICA plaque ulcer Present 5 (1 of 21) 33 (6 of 18) Absent 0 (0 of 5) 50 (2 of 4) Note.—Data are percentage (number) of procedures in which a new hyperintensity was noted for that angiograpic variable.
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