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Research ArticleINTERVENTIONAL

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
American Journal of Neuroradiology June 2006, 27 (6) 1321-1325;
R. du Mesnil de Rochemont
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S. Schneider
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B. Yan
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A. Lehr
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M. Sitzer
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J. Berkefeld
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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.).

Tables

  • Figures
  • Filter types used in this study

    Nitinol Filaments + Synthetic Membrane
    Material DesignConcentricEccentricNitinol Basket
    TypeAccunetAngioGuardEmboShieldEPI FilterWire EXFilterWire EZSpider
    ManufacturerGuidantCordisAbbottBoston ScientificBoston Scientificev3
    Porus size115 μm100 μm150 μm80 μm110 μm110 μm
    Crossing profile3.2F3.2F3.7F3.9F3.2F3.2F
    Number used in this study21517169
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American Journal of Neuroradiology: 27 (6)
American Journal of Neuroradiology
Vol. 27, Issue 6
June 2006
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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, J. Berkefeld
American Journal of Neuroradiology Jun 2006, 27 (6) 1321-1325;

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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, J. Berkefeld
American Journal of Neuroradiology Jun 2006, 27 (6) 1321-1325;
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Cited By...

  • Can Doppler Flow Parameters of Carotid Stenosis Predict the Occurrence of New Ischemic Brain Lesions Detected by Diffusion-Weighted MR Imaging after Filter-Protected Internal Carotid Artery Stenting?
  • New Ischemic Brain Lesions on Diffusion-Weighted MRI after Carotid Artery Stenting with Filter Protection: Frequency and Relationship with Plaque Morphology
  • The Influence of Carotid Artery Catheterization Technique on the Incidence of Thromboembolism during Carotid Artery Stenting
  • Late Cerebral Embolization After Emboli-Protected Carotid Artery Stenting Assessed by Sequential Diffusion-Weighted Magnetic Resonance Imaging
  • New Brain Lesions After Carotid Stenting Versus Carotid Endarterectomy: A Systematic Review of the Literature
  • Advances in Interventional Neuroradiology 2006
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