The Role of White Matter Damage in the Risk of Periprocedural Diffusion-Weighted Lesions after Carotid Artery Stenting
| العنوان: | The Role of White Matter Damage in the Risk of Periprocedural Diffusion-Weighted Lesions after Carotid Artery Stenting |
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| المؤلفون: | Francesco Passarelli, Domenico Lupoi, Patrizio Pasqualetti, Rosario Francesco Grasso, Mauro Silvestrini, Francesco Tibuzzi, Fabrizio Fiacco, Roberto Arpesani, Paola Maggio, Giacomo Luppi, Fabrizio Vernieri, Riccardo Altavilla, Claudia Altamura, Matteo Paolucci, Guido Di Giambattista |
| المصدر: | Cerebrovascular Diseases Extra Cerebrovascular Diseases Extra, Vol 7, Iss 1, Pp 1-8 (2017) |
| بيانات النشر: | S. Karger AG, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, Carotid arteries, 030204 cardiovascular system & hematology, Risk Assessment, White matter, 03 medical and health sciences, 0302 clinical medicine, Leukoencephalopathies, Predictive Value of Tests, Risk Factors, Carotid artery disease, Internal medicine, medicine, White matter hyperintensities, Odds Ratio, Humans, Carotid Stenosis, cardiovascular diseases, Risk factor, Aged, Retrospective Studies, Aged, 80 and over, carotid artery stenting, diffusion-weighted images, white matter hyperintensities, aged, aged, 80 and over, angioplasty, balloon, carotid stenosis, chi-square distribution, female, humans, intracranial embolism, italy, leukoencephalopathies, logistic models, male, multivariate analysis, odds ratio, predictive value of tests, retrospective studies, riska assessment, risk factors, treatment outcome, diffusion magnetic resonance imaging, stents, Original Paper, Chi-Square Distribution, business.industry, medicine.disease, Hyperintensity, medicine.anatomical_structure, Diffusion-weighted images, Diffusion Magnetic Resonance Imaging, Logistic Models, Treatment Outcome, Neurology, Intracranial Embolism, Italy, lcsh:RC666-701, Multivariate Analysis, Cardiology, Female, Stents, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery, Angioplasty, Balloon, Carotid artery stenting |
| الوصف: | Background: White matter hyperintensities (WMH) are a common finding in aged individuals affected by carotid artery disease and are a risk factor for first-ever and recurrent stroke. We investigated if white matter damage increases the risk of brain microembolism during carotid artery stenting (CAS), as evaluated by the appearance of new areas of restricted diffusion on diffusion-weighted images (DWI). Methods: We evaluated 47 patients with severe internal carotid artery (ICA) stenosis undergoing CAS, comparing preprocedural clinical, ultrasound and radiological characteristics. WMH volume was computed on FLAIR images before CAS. After CAS, the DWI scan was looked over for areas of restricted diffusion (DWI lesions). A first univariate analysis was adopted to compare groups according to the occurrence of DWI lesions. Then, the variable DWI lesion was modelled by means of a logistic regression model. Results: Seventeen patients developed at least 1 DWI lesion after CAS. Compared with non-DWI, DWI patients were more commonly treated in the left ICA (p = 0.007) and had a more severe WMH damage (p = 0.027). Indeed, the risk of a DWI lesion was higher in left versus right stenosis (OR = 9.0, 95% CI 1.9-42.7, p = 0.005) and increased for each log-unit of WMH lesion load (OR = 7.05, 95% CI 1.07-46.49, p = 0.042). A WMH lesion load of at least 5.25 cm3 had a 50% probability of occurrence of a new DWI lesion. Conclusions: Treated side and preexisting white matter damage are risk conditions for brain microembolism during CAS. This should be taken into account to optimize severe carotid artery disease management. |
| اللغة: | English |
| تدمد: | 1664-5456 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c16ac08ff252b606168a9f60ab6cdff6Test http://europepmc.org/articles/PMC5340215Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....c16ac08ff252b606168a9f60ab6cdff6 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 16645456 |
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