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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleINTERVENTIONAL

MR and Clinical Follow-Up of Diffusion-Weighted Cerebral Lesions after Carotid Artery Stenting

Elke A.M. Hauth, Christian Jansen, Robert Drescher, Michael Schwartz, Michael Forsting, Horst J. Jaeger and Klaus D. Mathias
American Journal of Neuroradiology October 2005, 26 (9) 2336-2341;
Elke A.M. Hauth
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Christian Jansen
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Robert Drescher
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Michael Schwartz
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Michael Forsting
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Horst J. Jaeger
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Klaus D. Mathias
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  • Fig 1.
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    Fig 1.

    Symptomatic stenosis of the right CA in a 62-year-old man.

    A, Preprocedural DW MR image (6000/103/1) shows a preprocedural lesion in the cortical territory of the MCA (white arrow).

    B, Preprocedural T2-weighted MR image (5700/119/1) shows no lesions in the cerebellar hemisphere in C.

    C, Postprocedural DW MR image (6000/103/1) shows the preprocedural lesion in the cortical territory of the MCA and a new ipsilateral lesion (<10 mm) in the right cerebellar hemisphere (white arrow).

    D, Postprocedural T2-weighted MR image (5700/119/1) obtained at a corresponding level shows the lesion in the cerebellar hemisphere in C (white arrow).

    E, T2-weighted MR image 6 months after the procedures shows the persistent area of hyperintensity (white arrow).

  • Fig 2.
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    Fig 2.

    Stent implantation of the left CA in a 64-year-old woman.

    A, Postprocedural T2-weighted image shows no lesion.

    B, T2-weighted MR image 6 months after the procedures shows a new area of hyperintensitiy in the territory of the contralateral MCA (white arrow).

Tables

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    TABLE 1:

    Patient characteristics

    n (%)
    Sex
        Male73 (70)
        Female32 (30)
    Age (y)*67.2 ± 8.2 (47–87)
    Medical history
        Hypertension89 (85)
        Diabetes mellitus54 (51)
        Hypercholesterolemia88 (84)
        Coronary artery disease91 (87)
        Peripheral vascular disease56 (53)
        Cardiac arrhythmia39 (37)
    • * Data are mean ± SD (range).

    • View popup
    TABLE 2:

    Characteristics of stenoses and procedures

    n (%)
    Ipsilateral symptoms
        Present at last 3 mo(72)
        Absent29 (28)
    Side
        Right56 (58)
        Left49 (47)
    Grade (%)*8.4 ± 6.4 (69–96)
        0–290 (0)
        30–691 (1)
        70–99104 (99)
    Location
        ICA at bifurcation75 (72)
        Proximal ICA26 (25)
        CCA4 (3)
    Morphology
        Eccentric87 (83)
        Concentric18 (17)
    • Note.—ICA indicates internal carotid artery; CCA, contralateral carotid artery.

    • * Data are mean ± SD (range).

    • View popup
    TABLE 3:

    Characteristics and results of follow-up of DW lesions

    DW Lesions (%)DW Lesions Postprocedural*DW Lesions Follow-up*
    No. of lesions
        Total6422
        Average2.9nana
        Range1–11nana
    Size (mm)
        <552 (81)00
        5–1012 (19)22
        >10000
    Vertical distribution (area of brain)
        Upper41 (64)00
        Middle15 (23)11
        Lower8 (13)11
    Horizontal distribution
        Cortical/subcortical59 (92)00
        Deep5 (8)22
    Cerebral distribution
        Frontal lobe11 (17)00
        Parietal lobe36 (56)00
        Temporal lobe6 (9)00
        Occipital lobe7 (11)00
        Cerebellar3 (5)11
        Basal ganglia000
        Thalamus1 (2)11
    Vascular distribution of branches
        ACA cortical5 (8)00
        ACA deep000
        MCA cortical50 (78)00
        MCA deep2 (3)11
        PCA cortical4 (6)00
        PICA3 (5)11
    • Note.—DW indicates diffusion-weighted; ACA, anterior cerebral artery; MCA, middle cerebral artery; PCA, posterior cerebral artery.

    • * T2-weighted magnetic resonance imaging.

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American Journal of Neuroradiology: 26 (9)
American Journal of Neuroradiology
Vol. 26, Issue 9
1 Oct 2005
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Elke A.M. Hauth, Christian Jansen, Robert Drescher, Michael Schwartz, Michael Forsting, Horst J. Jaeger, Klaus D. Mathias
MR and Clinical Follow-Up of Diffusion-Weighted Cerebral Lesions after Carotid Artery Stenting
American Journal of Neuroradiology Oct 2005, 26 (9) 2336-2341;

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MR and Clinical Follow-Up of Diffusion-Weighted Cerebral Lesions after Carotid Artery Stenting
Elke A.M. Hauth, Christian Jansen, Robert Drescher, Michael Schwartz, Michael Forsting, Horst J. Jaeger, Klaus D. Mathias
American Journal of Neuroradiology Oct 2005, 26 (9) 2336-2341;
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Cited By...

  • Impact of Perioperative Infarcts After Cardiac Surgery
  • Ischemic Brain Lesions After Carotid Artery Stenting Increase Future Cerebrovascular Risk
  • Predictors of Acute and Persisting Ischemic Brain Lesions in Patients Randomized to Carotid Stenting or Endarterectomy
  • The Influence of Carotid Artery Catheterization Technique on the Incidence of Thromboembolism during Carotid Artery Stenting
  • Assessing Carotid Revascularization: Should We Abandon the Neurological Examination?
  • New Brain Lesions After Carotid Stenting Versus Carotid Endarterectomy: A Systematic Review of the Literature
  • New MRI Brain Lesions as Surrogate Outcome for Carotid Stenting With and Without Cerebral Protection
  • Response to Letter by Wong and Poon
  • Incidence of New Brain Lesions After Carotid Stenting With and Without Cerebral Protection
  • Advances in Interventional Neuroradiology 2005
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More in this TOC Section

  • Endovascular Management of Intracranial Dural AVFs: Transvenous Approach
  • A Meta-analysis of Combined Aspiration Catheter and Stent Retriever versus Stent Retriever Alone for Large-Vessel Occlusion Ischemic Stroke
  • Follow-up of Intracranial Aneurysms Treated by Flow Diverters: Evaluation of Parent Artery Patency Using 3D-T1 Gradient Recalled-Echo Imaging with 2-Point Dixon in Combination with 3D-TOF-MRA with Compressed Sensing
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