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

Late Evaluation of Silent Cerebral Ischemia Detected by Diffusion-Weighted MR Imaging after... This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A1102v1 29/7/1340 most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Palombo, G. Articles by Taurino, M. Search for Related Content PubMed PubMed Citation Articles by Palombo, G. Articles by Taurino, M. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 29:1340-1343, August 2008 © 2008 American Society of Neuroradiology BRAIN Late Evaluation of Silent Cerebral Ischemia Detected by Diffusion-Weighted MR Imaging after Filter-Protected Carotid Artery Stenting G. Palombo a , V. Faraglia a , N. Stella a , E. Giugni b , A. Bozzao b and M. Taurino a a Departments of Vascular Surgery, Ospedale Sant’Andrea, "La Sapienza " University of Rome (Second Medical School), Rome, Italy b Departments of Neuroradiology, Ospedale Sant’Andrea, "La Sapienza " University of Rome (Second Medical School), Rome, Italy Please address correspondence to Giovanni Palombo, MD, Department of Vascular Surgery, Ospedale Sant’Andrea, Via di Grottarossa 1035, 00189 Rome, Italy; e-mail: giovanni.palombo@tiscali.it BACKGROUND AND PURPOSE: Postoperative diffusion-weighted MR imaging (DWI) often discloses new lesions after carotid artery stent placement (CAS), most of them asymptomatic. Our aim was to investigate the fate of these silent ischemic lesions. MATERIALS AND METHODS: We prospectively studied 110 patients undergoing protected transfemoral CAS, 98 of whom underwent DWI before and after the intervention. Patients in whom DWI disclosed silent postoperative lesions also had delayed MR imaging. Preoperative, postoperative, and delayed scans were compared. RESULTS: Of the 92 patients without postoperative symptoms, DWI disclosed 33 new silent ischemic lesions in 14 patients (15.2%), 13 of whom (30 lesions) underwent delayed MR imaging after a mean follow-up of 6.2 months. In 8 of these 13 patients (61%), MR imaging disclosed 12 persistent lesions (12/30, 40%). The reversibility rate depended significantly on the location (cortical versus subcortical) and size (0–5 versus 5–10 mm) of the lesions ( P < .05 by 2 test). CONCLUSIONS: Because many silent ischemic lesions seen on postoperative DWI after CAS reverse within months, the extent of permanent CAS-related cerebral damage may be overestimated. This article has been cited by other articles: C. J. White Proximal Embolic Protection: A "Game Changer" for Carotid Stents J. Am. Coll. Cardiol., April 20, 2010; 55(16): 1668 - 1670. Full Text PDF Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

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

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Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2010 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A1102
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See Article on Publisher Site

Abstract

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A1102v1 29/7/1340 most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Palombo, G. Articles by Taurino, M. Search for Related Content PubMed PubMed Citation Articles by Palombo, G. Articles by Taurino, M. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 29:1340-1343, August 2008 © 2008 American Society of Neuroradiology BRAIN Late Evaluation of Silent Cerebral Ischemia Detected by Diffusion-Weighted MR Imaging after Filter-Protected Carotid Artery Stenting G. Palombo a , V. Faraglia a , N. Stella a , E. Giugni b , A. Bozzao b and M. Taurino a a Departments of Vascular Surgery, Ospedale Sant’Andrea, "La Sapienza " University of Rome (Second Medical School), Rome, Italy b Departments of Neuroradiology, Ospedale Sant’Andrea, "La Sapienza " University of Rome (Second Medical School), Rome, Italy Please address correspondence to Giovanni Palombo, MD, Department of Vascular Surgery, Ospedale Sant’Andrea, Via di Grottarossa 1035, 00189 Rome, Italy; e-mail: giovanni.palombo@tiscali.it BACKGROUND AND PURPOSE: Postoperative diffusion-weighted MR imaging (DWI) often discloses new lesions after carotid artery stent placement (CAS), most of them asymptomatic. Our aim was to investigate the fate of these silent ischemic lesions. MATERIALS AND METHODS: We prospectively studied 110 patients undergoing protected transfemoral CAS, 98 of whom underwent DWI before and after the intervention. Patients in whom DWI disclosed silent postoperative lesions also had delayed MR imaging. Preoperative, postoperative, and delayed scans were compared. RESULTS: Of the 92 patients without postoperative symptoms, DWI disclosed 33 new silent ischemic lesions in 14 patients (15.2%), 13 of whom (30 lesions) underwent delayed MR imaging after a mean follow-up of 6.2 months. In 8 of these 13 patients (61%), MR imaging disclosed 12 persistent lesions (12/30, 40%). The reversibility rate depended significantly on the location (cortical versus subcortical) and size (0–5 versus 5–10 mm) of the lesions ( P < .05 by 2 test). CONCLUSIONS: Because many silent ischemic lesions seen on postoperative DWI after CAS reverse within months, the extent of permanent CAS-related cerebral damage may be overestimated. This article has been cited by other articles: C. J. White Proximal Embolic Protection: A "Game Changer" for Carotid Stents J. Am. Coll. Cardiol., April 20, 2010; 55(16): 1668 - 1670. Full Text PDF Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X

Journal

American Journal of Neuroradiology – American Journal of Neuroradiology

Published: Aug 1, 2008

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