Atherosclerotic plaque characteristics and the risk of brain ischemia during internal carotid artery stenting
Authors:
F. Charvát 1; J. Vrána 1; D. Netuka 2; F. Cihlář 3; A. Krajina 4; V. Chovanec 4; R. Herzig 5; V. Procházka 6; M. Roubec 7; P. Kešnerová 8; D. Školoudík 7; Pro Antique Trial Group 9
Authors‘ workplace:
D. Hořínek, M. Sameš, J. Neumann, M. Orlický, D. Součková, D. Ospalík, S. Vachtlová, T. Moravec, Z. Šustrová, A. Malucelli (Krajská zdravotní a. s., Ústí nad Labem)
; M. Bar, J. Havelka, T. Jonszta, T. Fadrná (FN Ostrava)
; M. Lojík, J. Raupach, Z. Bělobrádek, J. Jandura, D. Krajíčková, M. Rek, Z. Horčičiková (FN Hradec Králové)
; Radiologická klinika, Komplexní cerebrovaskulární centrum, ÚVN – VFN Praha
1; Neurochirurgická klinika, Komplexní cerebrovaskulární centrum, ÚVN – VFN Praha
2; Radiologická klinika, Komplexní cerebrovaskulární centrum, Masarykova nemocnice o. z., Krajská zdravotní a. s., FZS Univerzity J. E. Purkyně, Ústí nad Labem
3; Radiologická klinika, Komplexní cerebrovaskulární centrum, LF UK a FN Hradec Králové
4; Neurologická klinika, Komplexní cerebrovaskulární centrum, LF UK a FN Hradec Králové
5; Ústav radiodiagnostický, Komplexní cerebrovaskulární centrum, FN Ostrava
6; Neurologická klinika, Komplexní cerebrovaskulární centrum, FN Ostrava
7; Neurologická klinika, Komplexní cerebrovaskulární centrum, 2. LF UK a FN Motol, Praha
8; ANTIQUE Trial Group:T. Belšan, L. Coufalová, J. Meluzín, K. Broulíková, O. Krahula (ÚVN - VFN Praha)
9
Published in:
Cesk Slov Neurol N 2020; 83(1): 84-94
Category:
Original Paper
doi:
https://doi.org/10.14735/amcsnn202084
Overview
Aim: The aim of a prospective multicenter study was to determine whether the risk of developing a new ischemic brain lesion on control MRI is dependent on some of the characteristics of atherosclerotic plaque detected by duplex sonography, MRI and CTA.
Materials and methods: Patients with internal carotid artery stenosis (70– 95%) indicated for carotid angioplasty and stenting (CAS) were consecutively included in the prospective observational study. All enrolled patients underwent neurological and physical examinations, duplex sonographic examination of the carotid arteries with evaluation of the structure of atherosclerotic plaque in the ultrasound B-mode, CTA of the cervical and cerebral arteries and MRI of the neck and brain. The univariate and multivariate logistic regression analyses were performed to identify factors affecting the risk of the onset of brain ischemia following CAS.
Results: A total of 121 patients (93 males, age 70.5 ± 7.6 years) were enrolled in the study. Within 30 days of the CAS, 4 patients suffered from stroke, 1 patient suffered from a transient ischemic attack and 1 patient died. A new ischemic lesion on control brain MRI was detected in 34 (28.1%) patients. Using univariate and multivariate logistic regression analysis, no predictor (atherosclerotic plaque characteristics, history data, CAS data) was found to influence the risk of the onset of new brain ischemia.
Conclusion: Characteristics of atherosclerotic plaque in the area of the internal carotid artery stenosis does not affect the risk of developing brain ischemia detected by brain MRI following CAS.
Keywords:
Atherosclerosis – ultrasound – stent – internal carotid artery – Stenosis – magnetic resonance imaging
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