Document Detail

Frequency, clinical significance and course of cerebral ischemic events after carotid endarterectomy evaluated by serial diffusion weighted imaging.
MedLine Citation:
PMID:  14718899     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Neurological deficit defines the outcome of Carotid Endarterectomy (CEA) that is mainly caused by cerebral ischemia. Diffusion-weighted imaging (DWI) is a sensitive method for demonstrating even small ischemic lesions. The aim of this study was to evaluate the frequency, clinical significance and course of ischemic lesions after CEA using serial DWI. METHODS: DWI was performed within 1 day before and after CEA in 88 patients. Postoperative lesions were analyzed by their quantity, volume and distribution. To differentiate temporary ischemia from definite cerebral infarction (blood brain barrier disruption) all patients with a positive postoperative DWI were reexamined with contrast-enhanced T1-MRI 7-10 days after the procedure. All patients were examined by a neurologist within 2 days before and after CEA. RESULTS: Two patients showed a postoperative neurological deficit. Postoperative DWI revealed ipsilateral ischemic lesions in 15 patients. In seven of these patients a brain infarction was diagnosed on the T1-MRI during follow-up. A significant correlation between the number of DWI lesions (p=0.031) as well as the volume of DWI lesions (p=0.023) and definite infarction was found. Symptomatic patients preoperatively showed significantly more DWI lesions (p=0.036) and cerebral infarcts (p=0.003). CONCLUSION: DWI is a sensitive method of demonstrating ischemic events after CEA. The number and volume of DWI lesions after CEA are highly predictive of brain infarction.
O Wolf; P Heider; M Heinz; H Poppert; T Schmidt-Thieme; D Sander; H Gräfin von Einsiedel; R Brandl
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  27     ISSN:  1078-5884     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-01-13     Completed Date:  2004-02-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  167-71     Citation Subset:  IM    
Department of Vascular Surgery, Technical University of Munich, Germany.
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MeSH Terms
Brain / pathology
Cerebral Infarction / diagnosis*
Diffusion Magnetic Resonance Imaging*
Endarterectomy, Carotid*
Ischemic Attack, Transient / diagnosis*
Postoperative Complications / diagnosis*

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