Late Evaluation of Silent Cerebral Ischemia Detected by Diffusion-Weighted MR Imaging after Filter-Protected Carotid Artery Stenting

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Fig 1.
A, Ischemic lesion (arrow) seen on postoperative DWI. B, Delayed MR image in the same patient documents its disappearance.

Table 1:

Baseline characteristics of the 110 patients studied

Characteristics	No. (%)
Patients	110
Mean age (range) (years)	72.6 (56–86)
Men	78 (71)
Women	32 (29)
Ipsilateral ICA stenosis
70%–90%	106 (96.3)
>90%	4 (3.7)
Plaque structure
Type 5	12 (11)
Types 3 and 4	72 (65)
Types 1 and 2	26 (24)
Contralateral ICA stenosis
0%–50%	68 (62)
50%–69%	24 (22)
70%–99%	12 (11)
Occlusion	6 (5)
Presenting symptoms
TIA	24 (22)
Stroke	6 (5)
Asymptomatic	80 (73)
Vascular risk factors
Chronic renal failure	5 (4.5)
Hypertension	92 (84)
Cigarette smoking	49 (45)
Diabetes	45 (41)
Hyperlipidemia	60 (55)
Chronic obstructive pulmonary disease	8 (7)
Coronary artery disease	36 (33)
Peripheral vascular disease	17 (15)

Note:—TIA indicates transient ischemic attack; ICA, internal carotid artery.

Table 2:

Location of postoperative DWI ischemic lesions and after a mean 6.2-month follow-up

Location	Postoperative DWI	MR Imaging Follow-Up			P^*
Location	Postoperative DWI	Persisted	Disappeared	Lost	P^*
Cortical	19	4 (25%)	12 (75%)	3	.02
Subcortical	10	7 (70%)	3 (30%)	0
Deep white matter	3	1 (33%)	2 (66%)	0
Basal ganglia	1	0	1 (100%)	0
Total	33	12 (40%)	18 (60%)	3

Table 4:

Analysis of possible factors influencing patient reversibility rate

Factors	No. Patients with DWI Lesions	No. Patients with Persistent MR Imaging Lesions	P^*
Preoperative microinfarctual brain	6	3 (50%)	.3
Normal brain	1	0
Age ≥80 years	3	3 (100%)	.1
Age <80 years	10	5 (50%)
Types 1 and 2 carotid plaque	1	0	.2
Types 3–5 carotid plaque	12	8 (67%)
Asymptomatic	8	5 (62%)	.9
Symptomatic	5	3 (60%)