title: Propagation-based phase-contrast X-ray microtomography of a cerebral protection device retrieved after carotid artery stenting.
abstract: Phase-contrast synchrotron X-ray microtomography (pcSyncX) based on the highly coherent X-ray beam has previously been used to visualize the microstructures of biologic specimens, but it has never been used to evaluate embolic debris adherent on a cerebral protection device (CPD). The purpose of this study was to demonstrate the feasibility of pcSyncX for evaluating embolic debris during carotid artery stenting (CAS). Five patients (four males, age range 67-77 years) with severe carotid artery stenosis underwent CAS. The retrieved CPD was exposed to synchrotron radiation and 1000 pcSyncX projection images were obtained by rotating the CPD through 180°. An X-ray shadow of a CPD was converted into a visual image by the scintillator. After microtomographic reconstruction, the three-dimensionally reconstructed images were further segmented into the embolic debris and CPD. The total volume of emboli was calculated by summing the volume at each scanning level. The number of membrane pores covered by emboli as seen from the outer surface was counted and the percentage of covered area was calculated. Embolic debris was clearly demonstrated not only on the inner surface and within pores but also on the outer surface of the CPD. The mean total volume of embolic debris was 0.538 × 10(-6) mm(3) (range 0.225-0.965 × 10(-6) mm(3)). Most (61.5%) of the debris was located at the apical one-third of the CPD and 20.8% of the pore area was covered by debris.
authors.affiliation: Department of Radiology, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea.
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Youn
authors.affiliation: Department of Radiology, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea.
authors.forename: Ho Kyun
authors.initials: HK
authors.lastname: Kim
authors.affiliation: Department of Anatomy, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea.
authors.forename: Hong Tae
authors.initials: HT
authors.lastname: Kim
authors.affiliation: Department of Anatomy, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea.
authors.forename: Sung Mi
authors.initials: SM
authors.lastname: Han
authors.affiliation: Department of Neurology, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea.
authors.forename: Jin Kuk
authors.initials: JK
authors.lastname: Do
authors.affiliation: Department of Neurology, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea.
authors.forename: Young Rok
authors.initials: YR
authors.lastname: Do
authors.affiliation: Department of Radiology, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
authors.forename: Hui Joong
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Radiology, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
authors.forename: Jongmin
authors.initials: J
authors.lastname: Lee
authors.affiliation: X-ray Imaging Group, Beamline Division, Pohang Accelerator Laboratory, POSTECH, Pohang, Gyungbuk, Republic of Korea.
authors.forename: Jae Hong
authors.initials: JH
authors.lastname: Lim
mesh_terms: D000368:Aged; D016893:Carotid Stenosis / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005374:Filtration / Q000295:instrumentation*; D006801:Humans; D020766:Intracranial Embolism / Q000517:prevention & control*; D008297:Male; D011446:Prospective Studies; D015607:Stents / Q000009:adverse effects*; D055114:X-Ray Microtomography / Q000379:methods*
keywords: carotid artery stenting; cerebral protection device; embolic debris; microtomography; phase contrast; synchrotron X-rays