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Research ArticleBRAIN

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

G. Palombo, V. Faraglia, N. Stella, E. Giugni, A. Bozzao and M. Taurino
American Journal of Neuroradiology August 2008, 29 (7) 1340-1343; DOI: https://doi.org/10.3174/ajnr.A1102
G. Palombo
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V. Faraglia
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N. Stella
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E. Giugni
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A. Bozzao
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M. Taurino
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    Fig 1.

    A, Ischemic lesion (arrow) seen on postoperative DWI. B, Delayed MR image in the same patient documents its disappearance.

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    Table 1:

    Baseline characteristics of the 110 patients studied

    CharacteristicsNo. (%)
    Patients110
    Mean age (range) (years)72.6 (56–86)
    Men78 (71)
    Women32 (29)
    Ipsilateral ICA stenosis
        70%–90%106 (96.3)
        >90%4 (3.7)
    Plaque structure
        Type 512 (11)
        Types 3 and 472 (65)
        Types 1 and 226 (24)
    Contralateral ICA stenosis
        0%–50%68 (62)
        50%–69%24 (22)
        70%–99%12 (11)
    Occlusion6 (5)
    Presenting symptoms
        TIA24 (22)
        Stroke6 (5)
    Asymptomatic80 (73)
    Vascular risk factors
        Chronic renal failure5 (4.5)
        Hypertension92 (84)
        Cigarette smoking49 (45)
        Diabetes45 (41)
        Hyperlipidemia60 (55)
        Chronic obstructive pulmonary disease8 (7)
        Coronary artery disease36 (33)
        Peripheral vascular disease17 (15)
    • Note:—TIA indicates transient ischemic attack; ICA, internal carotid artery.

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    Table 2:

    Location of postoperative DWI ischemic lesions and after a mean 6.2-month follow-up

    LocationPostoperative DWIMR Imaging Follow-UpP*
    PersistedDisappearedLost
    Cortical194 (25%)12 (75%)3.02
    Subcortical107 (70%)3 (30%)0
    Deep white matter31 (33%)2 (66%)0
    Basal ganglia101 (100%)0
    Total3312 (40%)18 (60%)3
    • * P value by χ2 test.

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    Table 3:

    Size of postoperative DWI and follow-up MR imaging ischemic lesions

    SizePostoperative DWIFollow-Up MR ImagingP*
    PersistedDisappearedLost
    0–5 mm193 (17%)14 (83%)2.004
    5–10 mm149 (69%)4 (31%)1
    Total3312183
    • * P value by χ2 test.

    • View popup
    Table 4:

    Analysis of possible factors influencing patient reversibility rate

    FactorsNo. Patients with DWI LesionsNo. Patients with Persistent MR Imaging LesionsP*
    Preoperative microinfarctual brain63 (50%).3
    Normal brain10
    Age ≥80 years33 (100%).1
    Age <80 years105 (50%)
    Types 1 and 2 carotid plaque10.2
    Types 3–5 carotid plaque128 (67%)
    Asymptomatic85 (62%).9
    Symptomatic53 (60%)
    • * P values by χ2 test.

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American Journal of Neuroradiology: 29 (7)
American Journal of Neuroradiology
Vol. 29, Issue 7
August 2008
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Late Evaluation of Silent Cerebral Ischemia Detected by Diffusion-Weighted MR Imaging after Filter-Protected Carotid Artery Stenting
G. Palombo, V. Faraglia, N. Stella, E. Giugni, A. Bozzao, M. Taurino
American Journal of Neuroradiology Aug 2008, 29 (7) 1340-1343; DOI: 10.3174/ajnr.A1102

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Late Evaluation of Silent Cerebral Ischemia Detected by Diffusion-Weighted MR Imaging after Filter-Protected Carotid Artery Stenting
G. Palombo, V. Faraglia, N. Stella, E. Giugni, A. Bozzao, M. Taurino
American Journal of Neuroradiology Aug 2008, 29 (7) 1340-1343; DOI: 10.3174/ajnr.A1102
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  • Ischemic Brain Lesions After Carotid Artery Stenting Increase Future Cerebrovascular Risk
  • Predictors of Acute and Persisting Ischemic Brain Lesions in Patients Randomized to Carotid Stenting or Endarterectomy
  • Flow Reversal Versus Filter Protection: A Pilot Carotid Artery Stenting Randomized Trial
  • Characteristics of Ischemic Brain Lesions After Stenting or Endarterectomy for Symptomatic Carotid Artery Stenosis: Results From the International Carotid Stenting Study-Magnetic Resonance Imaging Substudy
  • Carotid Artery Stenting without Angioplasty and Cerebral Protection: A Single-Center Experience with up to 7 Years' Follow-Up
  • Proximal Embolic Protection: A "Game Changer" for Carotid Stents
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