New Brain Lesions After Carotid Stenting Versus Carotid Endarterectomy
Open Access
- 1 June 2008
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 39 (6), 1911-1919
- https://doi.org/10.1161/strokeaha.107.500603
Abstract
Background and Purpose— Against the background of a relatively low rate of clinical events during carotid angioplasty and stenting (CAS) or carotid endarterectomy (CEA), diffusion-weighted imaging (DWI) is increasingly being used to compare the incidence of new ischemic lesions after both procedures. In addition, DWI may also provide a means of defining the role of different CAS techniques on this adverse outcome. Therefore, we performed a PubMed search and systematically analyzed all peer-reviewed studies published between January 1990 and June 2007 reporting on the occurrence of new DWI lesions after CAS or CEA. Summary of Review— In 32 studies comprising 1363 CAS and 754 CEA procedures, the incidence of any new DWI lesion was significantly higher after CAS (37%) than after CEA (10%) ( P P P P P Conclusions— New DWI lesions occur more frequently after CAS than after CEA. However, technical advances mainly in the field of endovascular therapy potentially reduce the incidence of these adverse ischemic events. In this scenario, DWI appears to be an ideal tool to compare and further improve both techniques.Keywords
This publication has 50 references indexed in Scilit:
- Subclinical embolization after carotid artery stenting: New lesions on diffusion-weighted magnetic resonance imaging occur postprocedureJournal of Vascular Surgery, 2007
- Carotid artery stenting in octogenarians: results from the ALKK Carotid Artery Stent (CAS) RegistryEuropean Heart Journal, 2007
- 30 day results from the SPACE trial of stent-protected angioplasty versus carotid endarterectomy in symptomatic patients: a randomised non-inferiority trialThe Lancet, 2006
- Incidence of New Brain Lesions After Carotid Stenting With and Without Cerebral ProtectionStroke, 2006
- Cerebral microembolization after protected carotid artery stenting in surgical high-risk patients: Results of a 2-year prospective studyJournal of Vascular Surgery, 2005
- Silent Cerebral Ischemia Detected With Diffusion-Weighted Imaging in Patients Treated With Protected and Unprotected Carotid Artery StentingStroke, 2005
- Cerebral Ischemia After Carotid InterventionJournal of Endovascular Therapy, 2004
- Routine or Selective Carotid Artery Shunting for Carotid Endarterectomy (and Different Methods of Monitoring in Selective Shunting)Stroke, 2003
- Early Outcome of Carotid Angioplasty and Stenting With and Without Cerebral Protection DevicesStroke, 2003
- Endovaskuläre Behandlung hochgradiger Halsgefäßstenosen - Stentgestützte perkutane Angioplastie der Arteria Carotis ohne ProtektionRöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 2002