Key result
Carotid stenting linked to rapid white matter lesion reversal with ~10% higher axial diffusivity.
Why the study?
Age-related white matter lesions are commonly considered progressive, but evidence of partial reversal shortly after carotid artery stenting was not well documented.
Case Report (n=1)
No
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for rapid WM lesion reversal after stenting; prospective trials needed before clinical adoption.
Contrary to the common belief that age-related WMLs (also known as leukoaraiosis) are a progressive condition, a case of partial reversal of WMLs shortly after carotid artery stenting is described. A 75-year-old man presented with frequent TIAs, which were attributed to right ICA stenosis. He subsequently underwent successful carotid artery stenting. Follow-up MR imaging a week after the procedure showed improvement of WMLs in the right cerebral hemisphere. Pixel-by-pixel image analysis showed that the reversed WMLs tended to have higher lambda1 and lower signal intensity on b = 0 images compared with nonreversed lesions, but by only approximately 10%.
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Yamada et al. (2010) conducted a case report in Carotid Artery Stenosis with White Matter Lesions (n=1). Carotid artery stenting vs. Nonreversed white matter lesions (internal control) was evaluated on Axial diffusivity (λ1 × 10^-6) of reversed versus nonreversed white matter lesions (p=<0.001). Carotid artery stenting led to partial reversal of white matter lesions within one week, with reversed lesions showing 10% higher axial diffusivity and 11% lower signal intensity on b=0 images.
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