Cerebral Ischemia Detected with Diffusion-Weighted MR Imaging after Stent Implantation in the Carotid Artery
Horst J. Jaegera,
Klaus D. Mathiasa,
Elke Hautha,
Robert Dreschera,
H. Martin Gisslera,
Svenja Hennigsa and
Andreas Christmannb
a Department of Radiology, Staedtische Kliniken Dortmund and the Department of Radiology and MicroTherapy, University of Witten/Herdecke, Germany
b Department of Computer Science, University of Dortmund, Germany
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FIG 1. Images obtained in a 70-year-old man with an asymptomatic stenosis of the carotid artery.
A, Right anterior oblique angiogram shows a 94% stenosis of the right ICA.
B, Right anterior oblique angiogram shows the result after stent implantation.
C, Postprocedural axial diffusion-weighted MR image (6000/103/1) shows a new ipsilateral lesion (<5 mm) in the cortical territory of the MCA (arrow).
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FIG 2. Images obtained in a 86-year-old man with a symptomatic stenosis of the carotid artery.
A, Left anterior oblique angiogram (transbrachial approach) shows an 87% stenosis of the left ICA.
B, Left anterior oblique angiogram shows the result after stent implantation.
C, Postprocedural axial diffusion-weighted MR image (6000/103/1) shows six new ipsilateral lesions (5–10 mm) in the cortical territory of the ACA (arrow).
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FIG 3. Images obtained in a 73-year-old woman with a symptomatic stenosis of the carotid artery.
A, Left anterior oblique angiogram shows an 85% stenosis of the left ICA.
B, Left anterior oblique angiogram shows the result after stent implantation.
C, Postprocedural axial diffusion-weighted MR image (6000/103/1) shows eight new ipsilateral lesions (15–20 mm) in the cortical territory of the MCA (arrow).
D, Postprocedural axial T2-weighted MR image (5700/119/1) obtained at a corresponding level shows a new area of hyperintensity (arrow) that was not present in C.
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FIG 4. Images obtained in a 76-year-old woman with a symptomatic stenosis of the carotid artery.
A, Left anterior oblique angiogram shows a 79% stenosis of the left ICA.
B, Left anterior oblique angiogram shows the result after stent implantation.
C, Lateral angiogram shows the intracranial circulation of the treated side after a procedure with a nonocclusive embolus in a branch of the MCA (arrow). The patient was symptomatic during the whole procedure. An angiogram of the intracranial circulation obtained after the infusion of 100,000 IU of urokinase into the ICA demonstrated complete disappearance of the embolus (not shown).
D, Postprocedural axial diffusion-weighted MR image (6000/103/1) shows eight new ipsilateral lesions (5–10 mm) in the cortical territory of the MCA (arrow).
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