| Prediction of Silent Ischemic Lesions after Carotid Artery Stenting Using Virtual Histology Intravascular Ultrasound. | |
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MedLine Citation:
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PMID: 21709408 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background: A major concern with carotid artery stenting (CAS) is the potential for cerebral embolism. The purpose of this study was to determine whether virtual histology intravascular ultrasound (VH-IVUS) can predict the risk of a silent ischemic lesion after CAS. Methods: We performed CAS in 45 patients with carotid stenosis. Before CAS, we assessed plaque characteristics by VH-IVUS. We also performed diffusion-weighted magnetic resonance imaging of the brain before and after CAS to detect newly appearing ipsilateral silent ischemic lesions (NISIL). Results: In the patient group that was positive for NISIL (P group: n = 18), the relative fibrofatty (FF) area identified by VH-IVUS in 5 cross-sections including the most stenotic lesion was significantly larger than that in areas of the NISIL-negative group (N group: n = 27; 32.7 ± 13.2 and 18.3 ± 9.8%, respectively; p < 0.001). The relative fibrous area was significantly lower in the P group than in the N group (59.2 ± 9.5 and 74.6 ± 9.1%, respectively; p < 0.001). There were no differences in the relative dense calcium and necrotic core areas between the P and N groups. From the analysis of receiver operating characteristic curves, most reliable cutoff values for predicting NISIL were a relative FF area of 30% in the most stenotic lesion. In multivariate logistic regression analysis, the relative FF area was an independent predictor of NISIL (p = 0.005). Conclusions: Quantitative tissue characterization of atherosclerotic lesions of carotid arteries using VH-IVUS was useful to predict NISIL after CAS. However, the positive predictive value determined by VH-IVUS was not superior to that determined by a noninvasive method. |
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Authors:
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Kiyofumi Yamada; Shinichi Yoshimura; Masanori Kawasaki; Yukiko Enomoto; Kyohei Takano; Takahiko Asano; Shinya Minatoguchi; Toru Iwama |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-6-28 |
Journal Detail:
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Title: Cerebrovascular diseases (Basel, Switzerland) Volume: 32 ISSN: 1421-9786 ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-6-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9100851 Medline TA: Cerebrovasc Dis Country: - |
Other Details:
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Languages: ENG Pagination: 106-113 Citation Subset: - |
Copyright Information:
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Copyright © 2011 S. Karger AG, Basel. |
Affiliation:
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Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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