Ilaria Sansoni MD, Presenter: Nothing to Disclose

Andrea Laghi MD, Abstract Co-Author: Nothing to Disclose

Michela Celestre MD, Abstract Co-Author: Nothing to Disclose

Carlo Miglio MD, Abstract Co-Author: Nothing to Disclose

Luisa Coletta MD, Abstract Co-Author: Nothing to Disclose

Roberto Passariello MD, Abstract Co-Author: Nothing to Disclose

The aim of this study was to assess if brain diffusion-weighted MR imaging monitorization should be performed within 6 or 24 hours from carotid angioplasty and stent placement with protection device (CASPD).

Thirty-one consecutive patients referred for CASPD procedure (inclusion criteria: asymptomatic stenosis >80% or symptomatic stenosis >50%) underwent neurologic examination before, within 6 hours and 1 day after CASPD. We correlated positive results with risk factors, technical difficulties and plaque characteristics. MR protocol (FLAIR and DWI images) were performed 1-3 hours before, within 6 and 24 hours after CASPD, in order to verify the number of new ischemies (symptomatic or silent). Total examination time was 5 minutes. The three set of images were examined by two independent blinded reviewers for new high-signal areas suggestive for acute ischaemic lesions.

Within 6 hours DW-MRI images showed no new high signal intenstity lesions after stenting in all the cases. 24 hour DWI detected acute ischaemic lesions in 9,68% of patients, two symptomatic and one asymptomatic, and all three had two or more risk factors and a fibrocalcified plaque.

Embolic events may occur after CASPD, even if the use of early (within 6 hours) DW-MRI confirmed CASPD as a safe procedure, with no strictly procedure-related ischaemic complications. On the other hand, late (24 hours) DW-MRI monitorization showed the possibility of later embolization.

Sansoni, I, Laghi, A, Celestre, M, Miglio, C, Coletta, L, Passariello, R, Patients Underwent Carotid Stent Placement with Protection Device (CASPD): Role of Brain Diffusion-weighted MR Imaging within 6 and 24 Hours after Stenting.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4417040.html