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Atherosclerotic plaque characteristics and the risk of brain ischemia dur­­ing internal carotid artery stent­­ing


Authors: F. Charvát 1;  J. Vrána 1;  D. Netuka 2;  F. Cihlář 3;  A. Krajina 4;  V. Chovanec 4;  R. Herzig 5;  V. Procházka 6 ;  M. Roubec 7;  P. Kešnerová 8;  D. Školoudík 7;  Pro Antique Trial Group 9
Authors‘ workplace: D. Hořínek, M. Sameš, J. Neuman­n, M. Orlický, D. Součková, D. Ospalík, S. Vachtlová, T. Moravec, Z. Šustrová, A. Malucel­li (Krajská zdravotní a. s., Ústí nad Labem) ;  M. Bar, J. Havelka, T. Jonszta, T. Fadrná (FN Ostrava) ;  M. Lojík, J. Raupach, Z. Bělobrádek, J. Jandura, D. Krajíčková, M. Rek, Z. Horčičiková (FN Hradec Králové) ;  Radiologická klinika, Komplexní cerebrovaskulární centrum, ÚVN –  VFN Praha 1;  Neurochirurgická klinika, Komplexní cerebrovaskulární centrum, ÚVN –  VFN Praha 2;  Radiologická klinika, Komplexní cerebrovaskulární centrum, Masarykova nemocnice o. z., Krajská zdravotní a. s., FZS Univerzity J. E. Purkyně, Ústí nad Labem 3;  Radiologická klinika, Komplexní cerebrovaskulární centrum, LF UK a FN Hradec Králové 4;  Neurologická klinika, Komplexní cerebrovaskulární centrum, LF UK a FN Hradec Králové 5;  Ústav radiodia­gnostický, Komplexní cerebrovaskulární centrum, FN Ostrava 6;  Neurologická klinika, Komplexní cerebrovaskulární centrum, FN Ostrava 7;  Neurologická klinika, Komplexní cerebrovaskulární centrum, 2. LF UK a FN Motol, Praha 8;  ANTIQUE Trial Group:T. Belšan, L. Coufalová, J. Meluzín, K. Broulíková, O. Krahula (ÚVN - VFN Praha) 9
Published in: Cesk Slov Neurol N 2020; 83(1): 84-94
Category: Original Paper
doi: https://doi.org/10.14735/amcsnn202084

Overview

Aim: The aim of a prospective multicenter study was to determine whether the risk of develop­­ing a new ischemic brain lesion on control MRI is dependent on some of the characteristics of atherosclerotic plaque detected by duplex sonography, MRI and CTA.

Materials and methods: Patients with internal carotid artery stenosis (70– 95%) indicated for carotid angioplasty and stent­­ing (CAS) were consecutively included in the prospective observational study. All enrol­led patients underwent neurological and physical examinations, duplex sonographic examination of the carotid arteries with evaluation of the structure of atherosclerotic plaque in the ultrasound B-mode, CTA of the cervical and cerebral arteries and MRI of the neck and brain. The univariate and multivariate logistic regres­sion analyses were performed to identify factors af­fect­­ing the risk of the onset of brain ischemia following CAS.

Results: A total of 121 patients (93 males, age 70.5 ± 7.6 years) were enrol­led in the study. Within 30 days of the CAS, 4 patients suf­fered from stroke, 1 patient suf­fered from a transient ischemic attack and 1 patient died. A new ischemic lesion on control brain MRI was detected in 34 (28.1%) patients. Us­­ing univariate and multivariate logistic regres­sion analysis, no predictor (atherosclerotic plaque characteristics, history data, CAS data) was found to influence the risk of the onset of new brain ischemia.

Conclusion: Characteristics of atherosclerotic plaque in the area of the internal carotid artery stenosis does not af­fect the risk of develop­­ing brain ischemia detected by brain MRI following CAS.

Keywords:

Atherosclerosis – ultrasound – stent – internal carotid artery – Stenosis – magnetic resonance imaging


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Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

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