American Journal of Neuroradiology 26:2336-2341, October 2005
© 2005 American Society of Neuroradiology
INTERVENTIONAL
MR and Clinical Follow-Up of Diffusion-Weighted Cerebral Lesions after Carotid Artery Stenting
a Department of Radiology, Klinikum Dormund, Dormund, Federal Republic of Germany
b Department of Neurology, Klinikum Dormund, Dormund, Federal Republic of Germany
c Department of Radiology and Interventional Radiology, University Hospital Essen, Essen, Federal Republic of Germany
Address correspondence to Elke A.M. Hauth, MD, Department of Radiology and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, D-45122 Essen, Federal Republic of Germany
PURPOSE: The purpose of this prospective study was to determine the outcome of postprocedural cerebral diffusion-weighted (DW) MR lesions after carotid artery stent placement (CAS) and the incidence of new cerebral MR lesions 6 months after the procedure.
MATERIALS AND METHODS: DW and T2-weighted MR imaging of the brain and neurologic examinations were performed in 105 patients before and 24 hours and 6 months after CAS. In addition, a selective control angiography of the treated artery was performed after 6 months.
RESULTS: In 22 (21%) of 105 patients, DW MR images 24 hours after CAS showed 64 new neurologically silent lesions; 2 (3.1%) of these 64 lesions were also visible in T2-weighted MR images. The latter ones were still visible after 6 months. In the remaining 62 lesions, there were no abnormalities visible in DW and T2-weighted imaging at follow-up. In 2 (1.9%) of the 105 patients, new cerebral lesions were seen in T2-weighted images after 6 months; one patient was neurologically symptomatic. All others patients were neurologically unremarkable at 6-month follow-up.
CONCLUSIONS: Most postprocedural DW lesions showed no manifestations at 6-month MR follow-up and were clinically silent. This indicates that these lesions are potentially reversible and of no major neurologic sequelae. In addition, follow-up 6 months after CAS showed a very low incidence of new cerebral lesions and neurologic events.
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