Evaluation of carotid artery outward remodeling by T1-weighted magnetic resonance imaging in carotid endarterectomy and stenting
Abstract
We evaluated carotid artery outward remodeling and plaque relative signal intensity (rSI) using T1-weighted magnetic resonance imaging (T1-MRI) to investigate their clinical significance in carotid revascularization. From 86 patients undergoing carotid endarterectomy (CEA) or carotid artery stenting (CAS), 88 lesions (51 lesions treated with CEA and 37 lesions treated with CAS) were analyzed retrospectively. We evaluated the preoperative carotid artery remodeling index (CRI), determined by a ratio of the external cross-sectional vessel area at maximum stenosis and the reference cross-sectional vessel area at the distal portion of the internal carotid artery, and the plaque rSI, which is quantified as the ratio between the signal intensities of plaque and adjacent muscle using T1-MRI. We divided carotid lesions into four groups using the median values of CRI and rSI: L/L (CRI < 1.8, rSI < 2.5), H/L (CRI ≥ 1.8, rSI < 2.5), L/H (CRI < 1.8, rSI ≥ 2.5), and H/H (CRI ≥ 1.8, rSI ≥ 2.5). The primary end point was detection of acute ipsilateral ischemia on diffusion-weighted imaging (DWI) within 72 hours of treatment. Mean CRI and rSI were significantly higher in lesions treated with CEA than in those treated with CAS. Postoperative DWI...Continue Reading
References
Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis
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