AI Article Synopsis

  • White matter hyperintensities (WMH) are linked to an increased risk of strokes and may contribute to brain microembolism during carotid artery stenting (CAS).
  • In a study of 47 patients with severe internal carotid artery (ICA) stenosis, those with existing WMH damage had a higher likelihood of developing new diffusion-weighted imaging (DWI) lesions post-procedure.
  • Specifically, patients treated on the left ICA and those with a WMH volume over 5.25 cm³ had a significantly greater risk of experiencing new DWI lesions, suggesting the need for careful monitoring in these patients during CAS.

Article Abstract

Background: White matter hyperintensities (WMH) are a common finding in aged individuals affected by carotid artery disease and are a risk factor for first-ever and recurrent stroke. We investigated if white matter damage increases the risk of brain microembolism during carotid artery stenting (CAS), as evaluated by the appearance of new areas of restricted diffusion on diffusion-weighted images (DWI).

Methods: We evaluated 47 patients with severe internal carotid artery (ICA) stenosis undergoing CAS, comparing preprocedural clinical, ultrasound and radiological characteristics. WMH volume was computed on FLAIR images before CAS. After CAS, the DWI scan was looked over for areas of restricted diffusion (DWI lesions). A first univariate analysis was adopted to compare groups according to the occurrence of DWI lesions. Then, the variable DWI lesion was modelled by means of a logistic regression model.

Results: Seventeen patients developed at least 1 DWI lesion after CAS. Compared with non-DWI, DWI patients were more commonly treated in the left ICA (p = 0.007) and had a more severe WMH damage (p = 0.027). Indeed, the risk of a DWI lesion was higher in left versus right stenosis (OR = 9.0, 95% CI 1.9-42.7, p = 0.005) and increased for each log-unit of WMH lesion load (OR = 7.05, 95% CI 1.07-46.49, p = 0.042). A WMH lesion load of at least 5.25 cm3 had a 50% probability of occurrence of a new DWI lesion.

Conclusions: Treated side and preexisting white matter damage are risk conditions for brain microembolism during CAS. This should be taken into account to optimize severe carotid artery disease management.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5340215PMC
http://dx.doi.org/10.1159/000452717DOI Listing

Publication Analysis

Top Keywords

carotid artery
20
white matter
16
matter damage
12
dwi lesion
12
damage risk
8
artery stenting
8
artery disease
8
brain microembolism
8
areas restricted
8
restricted diffusion
8

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!