title: Can Doppler flow parameters of carotid stenosis predict the occurrence of new ischemic brain lesions detected by diffusion-weighted MR imaging after filter-protected internal carotid artery stenting?
abstract: OBJECTIVE
  Carotid angioplasty and stent placement are increasingly being used for the treatment of symptomatic and asymptomatic carotid artery disease. Carotid angioplasty and stent placement carry an inherent risk of distal cerebral embolization, precipitating new brain ischemic lesions and neurologic symptoms. Our purpose was to evaluate the frequency of new ischemic lesions found on diffusion-weighted imaging after protected carotid angioplasty and stent placement and to determine the association of new lesions with ICA Doppler flow parameters.
  
  
  METHODS
  Fifty-two patients (mean age, 68 ± 11 years) with 50%-69% (n = 20, group 1) and ≥70% (n = 32, group 2) internal carotid artery stenosis underwent carotid angioplasty and stent placement with distal filter protection. DWI was performed before and 48 hours after carotid angioplasty and stent placement.
  
  
  RESULTS
  Thirty-three (63.4%) patients showed new lesions. The average number of new postprocedural lesions was 3.4 per patient. Most of the postprocedural lesions were <5 mm (range, 3-23 mm), cortical and corticosubcortical, and clinically silent. Group 2 had a significantly higher number of new lesions compared with group 1 (P < .001). A significant relationship was found between ICA Doppler flow parameters and the appearance of new lesions.
  
  
  CONCLUSIONS
  The appearance of new ischemic lesions was significantly related to the Doppler flow parameters, particularly peak systolic velocity.
authors.affiliation: From the Departments of Radiology (Y.G., L.T.A.).
authors.forename: Y
authors.initials: Y
authors.lastname: Gunduz
authors.forename: R
authors.initials: R
authors.lastname: Akdemir
authors.forename: L T
authors.initials: LT
authors.lastname: Ayhan
authors.forename: N
authors.initials: N
authors.lastname: Keser
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D002545:Brain Ischemia / Q000473:pathology*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D002533:Cerebral Angiography; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D057505:Embolic Protection Devices; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015607:Stents; D013599:Systole; D014463:Ultrasonography