Lesion load in unprotected carotid artery stenting.
BACKGROUND
The purpose of the study was to determine the incidence of new ischemic lesions found on diffusion-weighted MR imaging (DWI) in nonselected patients after unprotected carotid artery stent placement.


METHODS
We retrospectively reviewed a nonrandomized cohort of 197 patients presenting with carotid occlusive disease who underwent unprotected carotid artery stent placement between 2003 and 2006. Mean degree of stenosis was 86.94% +/- 9.72. In all patients, DWI was obtained before and 24 h after stent placement. New lesions were evaluated according to size and location.


RESULTS
In 59 of 197 patients (29.9%), new ischemic lesions were found on DWI in the vessel dependent area. In 23 of 197 patients (11.7%), new ischemic lesions were found in the vessel independent area. Combined stroke/death rate was 3.63%.


CONCLUSIONS
In our series of unprotected carotid angioplasty with stent, we found new DWI lesions in 34% of the patients. Further studies should now show in how far protection devices can reduce these lesions.
Grunwald
I Q
IQ
Department for Diagnostic and Interventional Neuroradiology, University of the Saarland, Homburg, Germany. i.grunwald@gmx.net
Papanagiotou
P
P
Roth
C
C
Fassbender
K
K
Karp
K
K
Krick
C
C
Schieber
H
H
Müller
M
M
Haass
A
A
Reith
W
W
D001807:Blood Vessel Prosthesis; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000601:surgery*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D015607:Stents; D016896:Treatment Outcome