Why the study?
Does carotid angioplasty with stent placement compared to carotid endarterectomy increase the risk of DWI lesions in patients with carotid artery stenosis?
Does carotid angioplasty with stent placement compared to carotid endarterectomy increase the risk of DWI lesions in patients with carotid artery stenosis?
Diabetes, hyperlipidemia, symptomatic stenosis, older age, and carotid stenting are significant predictors of developing new ischemic brain lesions on MRI after carotid revascularization.
Diabetes, hyperlipidemia, symptomatic stenosis, age, and CAS predict post-revascularization DWI lesions; hypothesis-generating for risk stratification in observational data.
BACKGROUND: Diffusion-weighted imaging (DWI) abnormalities can frequently be detected after carotid endarterectomy (CEA) and carotid angioplasty with stent placement (CAS) of the carotid arteries. We looked for possible predictors for the development of DWI lesions during the intervention. METHODS: We investigated 41 patients who underwent CAS without protection devices and 93 patients who underwent CEA. DWI studies were performed 1 day before and after the intervention. RESULTS: Ischemic complications consisted of two strokes (2.2%) in the CEA group and one stroke (2.4%) in the CAS group. DWI lesions were detected in 28.0% of all patients after intervention. Using a multivariate regression analysis, diabetes mellitus (DM), hyperlipidemia, symptomatic stenosis, age and CAS were found to be significant predictors for the occurrence of DWI lesions. CONCLUSIONS: DWI is an objective and highly sensitive method for monitoring interventions of the carotid arteries. Our results point to an increased risk of patients with diabetes and hyperlipidemia to develop DWI lesions during invasive therapy of the ICA.
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Poppert et al. (2006) studied this question.
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