Diffusion-Weighted MR Imaging Lesions after Filter-Protected Stenting of High-Grade Symptomatic Carotid Artery Stenoses
R. du Mesnil de Rochemont,
S. Schneider,
B. Yan,
A. Lehr,
M. Sitzer and
J. Berkefeld
From the Institute of Neuroradiology, University of Frankfurt/Main, Germany
Department of Neurology, University of Frankfurt/Main, Germany
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Fig. 1. A, Number of new diffusion-weighted imaging (DWI) lesions after filter-protected carotid stent placement and median lesion load of DWI positive cases in different vascular territories.
B, Individual numbers and vascular territory of DWI lesions. Note case 16, with severe aortic arch atherosclerosis exceeding the usual number of 1 to 4 lesions per positive case.
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Fig. 2. Range of expression of diffusion-weighted imaging (DWI) lesions after filter-protected internal carotid artery (ICA) stent placement.
A and B, DWI the day before and the second day after stent placement of a right ICA stenosis. Upper limit of a small cortical infarct in the right middle cerebral artery (MCA) territory is visible on both images (arrow). Typical appearace of 2 new punctate lesions in the right parietal lobe (B).
C–E, Poststent DWI after endovascular treatment of a right ICA stenosis in the patient who showed the maximal number and extension of new lesions in this study. New hyperintensities are detected in the ipsilateral ICA as well as in the contralateral ICA (C and D) and vertebrobasilar territory (E). Note a pre-existing subacute infarct in the right MCA territory (arrowhead, D).
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Fig. 3. Diagrams showing potential influence factors for the occurrence of diffusion-weighted imaging (DWI) lesions after carotid stent placement.
A, Dependence between different age groups and DWI lesions was statistically significant (P = .01).
B, Trend toward lower rates of lesions with increasing experience of operators (n.s.).
C, Trend toward more DWI lesions with the use of segmented nitinol stents (Acculink) compared with Wallstents (n.s.).
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