Asymptomatic Cerebral Emboli Following Carotid Artery Stenting: A Diffusion-Weighted MRI Study

Background: Silent cranial embolism due to carotid artery stenting has been demonstrated to cause dementia, cognitive decline, and even ischemic stroke. The purpose of this study was to compare the periprocedural asymptomatic cranial embolism rates of different stent designs used for extracranial ca...

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Main Authors: Erkan Köklü, Şakir Arslan, Elif Sarıönder Gencer, Nermin Bayar, Çağın Mustafa Üreyen, Zehra Erkal, Ahmet Genç, Ramazan Güven, Oğuz Kaan Kaya, Muhammet Rıdvan Ersoysal
Format: Article
Language:English
Published: KARE Publishing 2022-12-01
Series:Anatolian Journal of Cardiology
Subjects:
Online Access:https://jag.journalagent.com/z4/download_fulltext.asp?pdir=anatoljcardiol&un=AJC-04571
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author Erkan Köklü
Şakir Arslan
Elif Sarıönder Gencer
Nermin Bayar
Çağın Mustafa Üreyen
Zehra Erkal
Ahmet Genç
Ramazan Güven
Oğuz Kaan Kaya
Muhammet Rıdvan Ersoysal
author_facet Erkan Köklü
Şakir Arslan
Elif Sarıönder Gencer
Nermin Bayar
Çağın Mustafa Üreyen
Zehra Erkal
Ahmet Genç
Ramazan Güven
Oğuz Kaan Kaya
Muhammet Rıdvan Ersoysal
author_sort Erkan Köklü
collection DOAJ
description Background: Silent cranial embolism due to carotid artery stenting has been demonstrated to cause dementia, cognitive decline, and even ischemic stroke. The purpose of this study was to compare the periprocedural asymptomatic cranial embolism rates of different stent designs used for extracranial carotid stenosis with diffusion-weighted magnetic resonance imaging. Methods: A total of 507 consecutive patients who underwent carotid artery stenting at our center from December 2010 to June 2020 (mean age, 66.4 +- 9.5) were analyzed retrospectively. The patients were divided into 3 groups as open-cell stent (334 patients), closed-cell stent (102 patients), and hybrid-cell stent (71 patients) groups. Diffusionweighted magnetic resonance imaging was performed for the patients before and after carotid artery stenting and compared. The diffusion limitations of 3 stent groups on cranial diffusion-weighted magnetic resonance imaging were compared with one another. Results: Periprocedural asymptomatic same-side microembolism, which was the primary endpoint of our study, was detected in 58 (17.4%) patients in the open-cell stent group, 6 (5.9%) patients in the closed-cell group, and 8 (11.3%) patients in the hybrid cell group, and overall in 72 (14.2%) patients. On diffusion-weighted magnetic resonance imaging, periprocedural asymptomatic same-side cranial embolism was found to be statistically significantly higher in the open-cell group compared to the other two groups (P=.011). Conclusions: The result of this study showed us that the rate of same-side cranial embolism detected on cranial diffusion-weighted magnetic resonance imaging after carotid artery stenting performed with open-cell stent was higher than those of the carotid artery stenting procedure performed with closed-cell and hybrid-cell stents.
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spelling doaj.art-2e70b3478cfe4e548737ccd9fad8d5d42023-11-07T17:38:42ZengKARE PublishingAnatolian Journal of Cardiology2149-22712022-12-0126429830410.5152/AnatolJCardiol.2021.970AJC-04571Asymptomatic Cerebral Emboli Following Carotid Artery Stenting: A Diffusion-Weighted MRI StudyErkan Köklü0Şakir Arslan1Elif Sarıönder Gencer2Nermin Bayar3Çağın Mustafa Üreyen4Zehra Erkal5Ahmet Genç6Ramazan Güven7Oğuz Kaan Kaya8Muhammet Rıdvan Ersoysal9Department of Cardiology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, TurkeyDepartment of Cardiology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, TurkeyDepartment of Neurology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, TurkeyDepartment of Cardiology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, TurkeyDepartment of Cardiology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, TurkeyDepartment of Cardiology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, TurkeyDepartment of Cardiology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, TurkeyClinic of Emergency Medicine, Başakşehir Çam and Sakura City Hospital, İstanbul, TurkeyDepartment of Cardiology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, TurkeyDepartment of Cardiology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, TurkeyBackground: Silent cranial embolism due to carotid artery stenting has been demonstrated to cause dementia, cognitive decline, and even ischemic stroke. The purpose of this study was to compare the periprocedural asymptomatic cranial embolism rates of different stent designs used for extracranial carotid stenosis with diffusion-weighted magnetic resonance imaging. Methods: A total of 507 consecutive patients who underwent carotid artery stenting at our center from December 2010 to June 2020 (mean age, 66.4 +- 9.5) were analyzed retrospectively. The patients were divided into 3 groups as open-cell stent (334 patients), closed-cell stent (102 patients), and hybrid-cell stent (71 patients) groups. Diffusionweighted magnetic resonance imaging was performed for the patients before and after carotid artery stenting and compared. The diffusion limitations of 3 stent groups on cranial diffusion-weighted magnetic resonance imaging were compared with one another. Results: Periprocedural asymptomatic same-side microembolism, which was the primary endpoint of our study, was detected in 58 (17.4%) patients in the open-cell stent group, 6 (5.9%) patients in the closed-cell group, and 8 (11.3%) patients in the hybrid cell group, and overall in 72 (14.2%) patients. On diffusion-weighted magnetic resonance imaging, periprocedural asymptomatic same-side cranial embolism was found to be statistically significantly higher in the open-cell group compared to the other two groups (P=.011). Conclusions: The result of this study showed us that the rate of same-side cranial embolism detected on cranial diffusion-weighted magnetic resonance imaging after carotid artery stenting performed with open-cell stent was higher than those of the carotid artery stenting procedure performed with closed-cell and hybrid-cell stents.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=anatoljcardiol&un=AJC-04571angioplastymagnetic resonance imagingstroke
spellingShingle Erkan Köklü
Şakir Arslan
Elif Sarıönder Gencer
Nermin Bayar
Çağın Mustafa Üreyen
Zehra Erkal
Ahmet Genç
Ramazan Güven
Oğuz Kaan Kaya
Muhammet Rıdvan Ersoysal
Asymptomatic Cerebral Emboli Following Carotid Artery Stenting: A Diffusion-Weighted MRI Study
Anatolian Journal of Cardiology
angioplasty
magnetic resonance imaging
stroke
title Asymptomatic Cerebral Emboli Following Carotid Artery Stenting: A Diffusion-Weighted MRI Study
title_full Asymptomatic Cerebral Emboli Following Carotid Artery Stenting: A Diffusion-Weighted MRI Study
title_fullStr Asymptomatic Cerebral Emboli Following Carotid Artery Stenting: A Diffusion-Weighted MRI Study
title_full_unstemmed Asymptomatic Cerebral Emboli Following Carotid Artery Stenting: A Diffusion-Weighted MRI Study
title_short Asymptomatic Cerebral Emboli Following Carotid Artery Stenting: A Diffusion-Weighted MRI Study
title_sort asymptomatic cerebral emboli following carotid artery stenting a diffusion weighted mri study
topic angioplasty
magnetic resonance imaging
stroke
url https://jag.journalagent.com/z4/download_fulltext.asp?pdir=anatoljcardiol&un=AJC-04571
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