MRI lesions after invasive therapy of carotid artery stenosis: a risk-modeling analysis.
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.
Poppert
H
H
Department of Neurology, Technical University of Munich, Muenchen, Germany. poppert@neuro.med.tu-muenchen.de
Wolf
O
O
Theiss
W
W
Heider
P
P
Hollweck
R
R
Roettinger
M
M
Sander
D
D
D000367:Age Factors; D000368:Aged; D000800:Angioplasty, Balloon; D016893:Carotid Stenosis / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D003920:Diabetes Mellitus / Q000503:physiopathology; D038524:Diffusion Magnetic Resonance Imaging; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D015607:Stents