title: Effect of Self-Expanding Carotid Stents on Plaque Thickness and Vessel Diameter.
abstract: BACKGROUND
  In vitro models have suggested that stents affect atherosclerotic plaques symmetrically because of their outward radial forces. We evaluated the effects of stents on carotid plaque and the arterial wall using carotid ultrasound in carotid stenting patients to see whether these effects were borne out in vivo.
  
  
  METHODS
  From a carotid stent database, 30 consecutive patients were selected. All had carotid Doppler ultrasound performed pre- and poststenting. The diameters of the lumen at the level of stenotic plaque pre- and poststenting, the dorsal and ventral plaque thickness, and of the outer arterial wall diameter were measured. Plaque thickness was measured at the level of maximal stenosis. Nonparametric tests were used to determine whether the stent effect and luminal enlargement were based on wall remodeling or on total arterial expansion.
  
  
  RESULTS
  The patients were followed for an average of 22 months. Eighteen patients were male, with an average age of 70 years. A total of 87% of patients were symptomatic ipsilateral to the side of stenosis. Nine patients had angioplasty intraprocedurally. The luminal diameter increased poststenting in the region of severe stenosis. Plaque thickness, both ventrally and dorsally, decreased poststenting, with no significant difference between the ventral and dorsal plaque effects. The outer arterial wall diameters did not change. The measured lumen in the stent increased over time poststenting.
  
  
  CONCLUSIONS
  Self-expanding nitinol stents alter the baseline ventral and dorsal plaque to a significant degree and do not significantly affect the native arterial wall and the overall arterial diameter.
authors.affiliation: 1Departments of Clinical Neurological Sciences,Schulich School of Medicine and Dentistry,Western University,London,Canada.
authors.forename: Rafael
authors.initials: R
authors.lastname: Martínez-Pérez
authors.affiliation: 1Departments of Clinical Neurological Sciences,Schulich School of Medicine and Dentistry,Western University,London,Canada.
authors.forename: Graeme
authors.initials: G
authors.lastname: Marchuk
authors.affiliation: 2Medical Imaging,Schulich School of Medicine and Dentistry,Western University,London,Canada.
authors.forename: Donald H
authors.initials: DH
authors.lastname: Lee
authors.affiliation: 2Medical Imaging,Schulich School of Medicine and Dentistry,Western University,London,Canada.
authors.forename: David M
authors.initials: DM
authors.lastname: Pelz
authors.affiliation: 1Departments of Clinical Neurological Sciences,Schulich School of Medicine and Dentistry,Western University,London,Canada.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Lownie
mesh_terms: D000368:Aged; D000497:Alloys / Q000627:therapeutic use; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D016893:Carotid Stenosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000473:pathology* / Q000628:therapy; D015607:Stents; D018608:Ultrasonography, Doppler / Q000379:methods
chemical_list: D000497:Alloys; C013616:nitinol
keywords: carotid artery; carotid stenosis; stent