Magnetic resonance imaging and clinical outcome in patients with symptomatic carotid artery stenosis after carotid artery revascularization

Badacz, Rafał; Kabłak‐Ziembicka, Anna; Urbańczyk‐Zawadzka, Małgorzata; Banyś, Robert; Musiałek, Piotr; Odrowąż-Pieniążek, Piotr; Trystuła, Mariusz; Ścigalski, Jan; Żmudka, Krzysztof; Przewłocki, Tadeusz

doi:10.5114/aic.2017.70190

Cited by 8 publications

(9 citation statements)

References 36 publications

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“…This data were supported by the results of the observational study in a group of 42 patients with high-grade, asymptomatic carotid artery stenosis, in which cognitive impairment correlated linearly with mean flow velocity below a threshold of < 45 cm/s in the hemisphere fed by the stenosed internal carotid artery [30]. In line, carotid artery stenosis may be associated with mild cognitive impairment in either neurologically symptomatic and asymptomatic patients [26,33]. Puz et al, in group of 60 patients with ulcerated plaque causing internal carotid artery stenosis ≥ 70%, showed reduced cerebrovascular reactivity, indicating important role of TCCD examination [34].…”

Section: Discussionsupporting

confidence: 52%

“…This unexpectedly high values of the RI and the PI in patients with DAS, that obviously indicate failure of the physiological autoregulation mechanism in response to reduced CBF, can be partially explained by the negative impact of age and coexisting comorbidities, such as diabetes, hyperlipidemia and hypertension resulting in the increased stiffness in the macro-vasculature and small-vessel disease [26][27][28][29].…”

Section: Discussionmentioning

confidence: 98%

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Assessment of the Willis circle flow changes and the severity of degenerative aortic stenosis and cognitive impairment

Baran¹,

Przewłocki²,

Podolec³

et al. 2021

Kardiol Pol

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 98%

Assessment of the Willis circle flow changes and the severity of degenerative aortic stenosis and cognitive impairment

Baran¹,

Przewłocki²,

Podolec³

et al. 2021

Kardiol Pol

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“…[17][18][19][20][21] However, Rafat et al found no association between the appearance of a high-signal-intensity area on DWI after surgery and higher brain hypofunction. 22) In this study, the KPOT II results significantly improved even in the DWI-positive group. However, deterioration was noted in one patient in this group, suggesting that the appearance of predominant-side cerebral infarction is involved in higher brain hypofunction.…”

Section: ) Appearance Of Positive Findings On Dwi and Higher Brain Fsupporting

confidence: 47%

Correlation between Higher Brain Dysfunction and Cerebral Blood Flow after Carotid Artery Stenting

Orimoto

Kobayashi

Abe

et al. 2021

JNET

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This study investigated the changes in higher brain function and cerebral blood flow (CBF) after carotid artery stenting (CAS), the relationship with CBF, and the impact of high intensities in diffusion-weighted imaging (DWI) after CAS. Method: We performed CAS between September 2017 and September 2019 in our department in 88 patients. Patients who did not undergo higher brain function tests according to our protocol or those who did not consent to participate in our study were excluded. This study targeted the 26 patients who were able to undergo the tests, including the Kana Pick-out Test (KPOT) II, three times: before, 1 week after, and 1-3 months after CAS. We investigated the chronological changes in higher brain function and their relationship with high intensity on DWI. Result: The results of Symbol Digit Modalities Tests (SDMT) and KPOT I and II improved significantly. There was a significant correlation between the improvement of higher brain function and CBF in patients with stenosis exceeding 60%, a score of the Mini-Mental State Examination (MMSE) of 26 or less, and without other cause of higher brain dysfunction, including known dementia. High-intensity spots on DWI after CAS had no significant impact on higher brain function. Conclusion: Higher brain function associated with attention and working memory improved significantly after CAS. There was a correlation between the improvement of higher brain function and CBF in patients with severe stenosis, mild cognitive impairment, and no known dementia. The prevention of subsequent ischemic attack and higher brain function should both be taken into account when performing CAS. Keywords▶ higher brain function, carotid artery stenting, hemodynamics This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License.

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“…The assessment of eligibility for interventional treatment in patients with symptomatic stenosis is based not only on the benefit in the secondary stroke prevention but also on data indicating the improvement of cerebral flow and perfusion and the functional outcome, as well as the potential positive impact on cognitive functions. 29 Treatment choice and the identification of patients at increased risk are much more difficult in asymptomatic individuals.…”

Section: Resultsmentioning

confidence: 99%

Factors associated with the symptomatic status of carotid artery stenosis: identification in a cross-sectional study and development of a scoring system

Puz¹,

Urbanek²,

Ziaja³

et al. 2020

Polish Archives of Internal Medicine

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INTROduCTIONThe identification of asymptomatic patients at high risk of internal carotid artery (ICA) stenosis destabilization and symptom occurrence is crucial for prognosis estimation.ObjECTIvEs This study aimed to determine differences between patients with symptomatic and asymptomatic ICA stenosis and to develop a predictive model for the risk of symptomatic stenosis based on data collected in routine clinical practice. PATIENTs ANd mEThOdsThe study included 163 patients with asymptomatic and 182 patients with symptomatic ICA stenosis greater than 70%. The study groups were compared in terms of stroke risk factors and comorbidities, coexisting ICA stenosis on the contralateral side, atherosclerosis in other arterial territories, and the morphology of atherosclerotic plaque assessed by transcervical ultrasound.REsuLTs Independent risk factors for symptomatic ICA stenosis included: male sex (odds ratio [OR], 2.94; 95% CI, 1.87-4.32; P <0.001), diabetes (OR, 2.86; 95% CI, 1.62-5.12; P <0.001), body mass index >25 kg/m 2 (OR, 1.81; 95% CI, 1.72-1.86; P <0.001), chronic kidney disease (OR, 3.34; 95% CI, 1.34-8.87; P = 0.007), increased -risk features of ultrasound plaque morphology (OR, 2.52; 95% CI, 1.29-3.72; P = 0.009), and coexisting atherosclerosis in 3 or 4 vascular areas (OR, 3.72; 95% CI, 1.77-7.23; P <0.001).The sensitivity and specificity of the scoring model designed to estimate the risk of symptomatic ICA stenosis reached 77.6% and 76.9%, respectively.CONCLusIONs This cross -sectional study indicated that the analysis of selected imaging and clinical parameters may enable clinicians to estimate the risk of symptomatic ICA stenosis. The proposed scoring system requires further prospective validation.

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Magnetic resonance imaging and clinical outcome in patients with symptomatic carotid artery stenosis after carotid artery revascularization

Cited by 8 publications

References 36 publications

Assessment of the Willis circle flow changes and the severity of degenerative aortic stenosis and cognitive impairment

Assessment of the Willis circle flow changes and the severity of degenerative aortic stenosis and cognitive impairment

Correlation between Higher Brain Dysfunction and Cerebral Blood Flow after Carotid Artery Stenting

Factors associated with the symptomatic status of carotid artery stenosis: identification in a cross-sectional study and development of a scoring system

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