Background and purpose: Carotid angioplasty and stenting, a so far non valida ted procedure, may be an alternative to surgery in patients with a high surgical risk. However, it carries also a risk of cerebral embolic ...Background and purpose: Carotid angioplasty and stenting, a so far non valida ted procedure, may be an alternative to surgery in patients with a high surgical risk. However, it carries also a risk of cerebral embolic events. The purpose o f this study was to evaluate tissue signal abnormalities in the brain before and after carotid angioplasty and stenting by means of diffu sion (DWI) and perfu sion (PWI) weighted magnetic resonance imaging (MRI). Methods: We performed cere bral MRI before and after carotid angioplasty in 22 consecutive patients, with 2 3 treated high grade carotid stenoses. The lesions were located at the origin o f the internal carotid artery (ICA) in 20 patients, and at the origin of the com mon carotid artery (CCA) in 2. MRI was performed the day before, and repeated wi thin 24 hours after the procedure, and examined by two neuroradiologists. Result s: All stent implantations were successful but 4 patients developed an acute neu rological deficit within 24 hours after carotid angioplasty. On PWI, Time To Pea k (TTP) values ipsilateral to the carotid stenosis were increased before the pro cedure in 15 patients, and had remained normal in 6 and were not assessable in 1 . After the procedure, TTP values were normal in 12 patients, increased in 8 and not assessable in 2. On DWI, new ipsilateral lesions were detected in 2 patient s: 1 with an acute neurological deficit and 1 symptom free. Conclusion: Perfusio n deficits may be present in severe carotid stenosis and be improved within 24 h ours by carotid angioplasty and stenting. Asymptomatic infarcts may occur.展开更多
文摘Background and purpose: Carotid angioplasty and stenting, a so far non valida ted procedure, may be an alternative to surgery in patients with a high surgical risk. However, it carries also a risk of cerebral embolic events. The purpose o f this study was to evaluate tissue signal abnormalities in the brain before and after carotid angioplasty and stenting by means of diffu sion (DWI) and perfu sion (PWI) weighted magnetic resonance imaging (MRI). Methods: We performed cere bral MRI before and after carotid angioplasty in 22 consecutive patients, with 2 3 treated high grade carotid stenoses. The lesions were located at the origin o f the internal carotid artery (ICA) in 20 patients, and at the origin of the com mon carotid artery (CCA) in 2. MRI was performed the day before, and repeated wi thin 24 hours after the procedure, and examined by two neuroradiologists. Result s: All stent implantations were successful but 4 patients developed an acute neu rological deficit within 24 hours after carotid angioplasty. On PWI, Time To Pea k (TTP) values ipsilateral to the carotid stenosis were increased before the pro cedure in 15 patients, and had remained normal in 6 and were not assessable in 1 . After the procedure, TTP values were normal in 12 patients, increased in 8 and not assessable in 2. On DWI, new ipsilateral lesions were detected in 2 patient s: 1 with an acute neurological deficit and 1 symptom free. Conclusion: Perfusio n deficits may be present in severe carotid stenosis and be improved within 24 h ours by carotid angioplasty and stenting. Asymptomatic infarcts may occur.
