MR and clinical follow-up of diffusion-weighted cerebral lesions after carotid artery stenting.
OBJECTIVE
The purpose of this prospective study was to determine the outcome of postprocedural cerebral diffusion-weighted (DW) MR lesions after carotid artery stent placement (CAS) and the incidence of new cerebral MR lesions 6 months after the procedure.


METHODS
DW and T2-weighted MR imaging of the brain and neurologic examinations were performed in 105 patients before and 24 hours and 6 months after CAS. In addition, a selective control angiography of the treated artery was performed after 6 months.


RESULTS
In 22 (21%) of 105 patients, DW MR images 24 hours after CAS showed 64 new neurologically silent lesions; 2 (3.1%) of these 64 lesions were also visible in T2-weighted MR images. The latter ones were still visible after 6 months. In the remaining 62 lesions, there were no abnormalities visible in DW and T2-weighted imaging at follow-up. In 2 (1.9%) of the 105 patients, new cerebral lesions were seen in T2-weighted images after 6 months; one patient was neurologically symptomatic. All others patients were neurologically unremarkable at 6-month follow-up.


CONCLUSIONS
Most postprocedural DW lesions showed no manifestations at 6-month MR follow-up and were clinically silent. This indicates that these lesions are potentially reversible and of no major neurologic sequelae. In addition, follow-up 6 months after CAS showed a very low incidence of new cerebral lesions and neurologic events.
Hauth
Elke A M
EA
Department of Radiology, Klinikum Dormund, Dormund, Federal Republic of Germany.
Jansen
Christian
C
Drescher
Robert
R
Schwartz
Michael
M
Forsting
Michael
M
Jaeger
Horst J
HJ
Mathias
Klaus D
KD
D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000009:adverse effects; D001921:Brain / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000473:pathology / Q000628:therapy*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000628:therapy; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015607:Stents / Q000009:adverse effects