Contenido en filtros tras angioplastia y colocación de stent carotídeo: relación con lesiones isquémicas en la resonancia magnética de difusión

Peña, Pilar Piñero González de la; García, Alejandro González; Álvarez, F. Moniche; Deya, Antonio Mayol; Marcos, José; Domínguez, Alejandro; Peralta, A. Gil

doi:10.1016/j.rx.2010.12.008

Cited by 2 publications

(9 citation statements)

References 34 publications

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“…Because of the risk of embolism during angiographic exams (diagnostic) and in interventional procedures such as CAS, we believe that the exams should be performed by certified and experienced neuroradiologists only. This statement is supported by other authors [71,79].…”

Section: Diffusion Mri Study After Cassupporting

confidence: 88%

“…All interventional procedures performed in craniofacial vascular regions carry an inherent risk of causing embolisms to the brain with different levels of severity. In these cases, the diffusion MRI technique is the most efficient tool for detecting acute focal cerebral ischemia [46,71,72].…”

Section: Diffusion Mri Study After Casmentioning

confidence: 99%

“…Several other authors [8,48,56,58,71,[80][81][82] studied risk factors for the occurrence of atherosclerotic disease and ICVA, including diabetes, hypertension, coronary artery disease, ischemic peripheral vascular disease, hypercholesterolemia, arrhythmia, previous ischemic stroke, previous TIA, vasculitis, and hemorrhagic cerebrovascular accident. Most authors did not find significant differences related to the appearance of hypersignal foci in DWI.…”

Section: Diffusion Mri Study After Casmentioning

confidence: 99%

“…Our idea about the vulnerability of plaque is shared by Piñero at al. [71], who evaluated the composition of the material found in the filters after CAS and stated that the atheromatous plaque and the vessel wall are the main sources of microemboli during CAS.…”

Section: Diffusion Mri Study After Casmentioning

confidence: 99%

“…Small NF (>5 mm) were reported as having the highest chance of not becoming definitive ischemic lesions in later MRI scans compared with NF larger than 5 mm [75]. In addition to the size of the foci in DWI, the topography may also determine whether the lesion will be clinically silent or not [56,71].…”

Section: Diffusion Mri Study After Casmentioning

confidence: 99%

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Cerebral Protection in Carotid Angioplasty – Is There a Need? Advantages and Disadvantages of Each Type of Protection Device

Tavares¹,

Caldas²

2014

Carotid Artery Disease - From Bench to Bedside and Beyond

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Currently, ischemic cerebral vascular accident (ICVA; stroke) is an illness with a high incidence and a high mortality rate [1,2]. In Brazil, depending on the state of the Brazilian Federation and the period analyzed, cerebrovascular disease is the leading cause of mortality [3]. Moreover, survivors present a continuous risk of developing serious complications [4]. Carotid atherosclerotic disease is the cause of approximately 15 to 20% of cerebrovascular accidents [5]. Carotid stenosis is present in 7% of men and 5% of women aged 65 years or older [6]. In serious cases (>70% stenosis), stenosis is an important cause of ICVA and transient ischemic attack (TIA). The estimated risk of ipsilateral ICVA in 5 years is 4% in the population without carotid stenosis; the risk increases to 18% in patients with asymptomatic stenosis above 75% and reaches 27% in symptomatic patients with stenosis >75% [7]. Several authors have described risk factors associated with carotid atherosclerosis, such as age, smoking, systemic arterial hypertension (SAH), hypercholesterolemia, coronary artery disease, peripheral vascular disease, and male gender [4,8,9]. 2. Treatment of carotid stenosis Treatment options for carotid stenosis include medication or surgery [10-12]. Clinical treatment includes antiplatelet agents and statins associated with the control of risk factors such as arterial hypertension, dyslipidemia, hyperglycemia, diabetes, and smoking [13]. Relevant studies comparing the outcomes of clinical treatment and surgery showed an important

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Section: Diffusion Mri Study After Cassupporting

confidence: 88%

Section: Diffusion Mri Study After Casmentioning

confidence: 99%

Section: Diffusion Mri Study After Casmentioning

confidence: 99%

Section: Diffusion Mri Study After Casmentioning

confidence: 99%

Section: Diffusion Mri Study After Casmentioning

confidence: 99%

See 3 more Smart Citations

Cerebral Protection in Carotid Angioplasty – Is There a Need? Advantages and Disadvantages of Each Type of Protection Device

Tavares¹,

Caldas²

2014

Carotid Artery Disease - From Bench to Bedside and Beyond

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Silent brain infarcts on diffusion-weighted imaging after carotid revascularisation: A surrogate outcome measure for procedural stroke? A systematic review and meta-analysis

Traenka

Engelter

Brown³

et al. 2019

European Stroke Journal

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Aim: To investigate whether lesions on diffusion-weighted imaging (DWIþ) after carotid artery stenting (CAS) or endarterectomy (CEA) might provide a surrogate outcome measure for procedural stroke. Materials and Methods: Systematic MedLine V R database search with selection of all studies published up to the end of 2016 in which DWI scans were obtained before and within seven days after CAS or CEA. The correlation between the underlying log odds of stroke and of DWIþ across all treatment groups (i.e. CAS or CEA groups) from included studies was estimated using a bivariate random effects logistic regression model. Relative risks of DWIþ and stroke in studies comparing CAS vs. CEA were estimated using fixed-effect Mantel-Haenszel models. Results: We included data of 4871 CAS and 2099 CEA procedures (85 studies). Across all treatment groups (CAS and CEA), the log odds for DWIþ was significantly associated with the log odds for clinically manifest stroke (correlation coefficient 0.61 (95% CI 0.27 to 0.87), p ¼ 0.0012). Across all carotid artery stenting groups, the correlation coefficient was 0.19 (p ¼ 0.074). There were too few CEA groups to reliably estimate a correlation coefficient in this subset alone. In 19 studies comparing CAS vs. CEA, the relative risks (95% confidence intervals) of DWIþ and stroke were 3.83 (3.17-4.63, p < 0.00001) and 2.38 (1.44-3.94, p ¼ 0.0007), respectively. Discussion: This systematic meta-analysis demonstrates a correlation between the occurrence of silent brain infarcts on diffusion-weighted imaging and the risk of clinically manifest stroke in carotid revascularisation procedures. Conclusion: Our findings strengthen the evidence base for the use of DWI as a surrogate outcome measure for procedural stroke in carotid revascularisation procedures. Further randomised studies comparing treatment effects on DWI lesions and clinical stroke are needed to fully establish surrogacy.

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Contenido en filtros tras angioplastia y colocación de stent carotídeo: relación con lesiones isquémicas en la resonancia magnética de difusión

Cited by 2 publications

References 34 publications

Cerebral Protection in Carotid Angioplasty – Is There a Need? Advantages and Disadvantages of Each Type of Protection Device

Cerebral Protection in Carotid Angioplasty – Is There a Need? Advantages and Disadvantages of Each Type of Protection Device

Silent brain infarcts on diffusion-weighted imaging after carotid revascularisation: A surrogate outcome measure for procedural stroke? A systematic review and meta-analysis

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