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Table of Contents
Vol. 33, No. 1, 2012
Issue release date: January 2012
Section title: Original Paper
Cerebrovasc Dis 2012;33:30–36
(DOI:10.1159/000332088)

Predictors of Periprocedural Brain Lesions Associated with Carotid Stenting

Russjan A.a · Goebell E.b · Havemeister S.a · Thomalla G.a · Cheng B.a · Beck C.a · Krützelmann A.a · Fiehler J.b · Gerloff C.a · Rosenkranz M.a
Departments of aNeurology and bNeuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: July 01, 2011
Accepted: August 22, 2011
Published online: November 30, 2011
Issue release date: January 2012

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 3

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: http://www.karger.com/CED

Abstract

Background: Carotid stenting carries a risk of periprocedural stroke. We aimed at determining predictors of cerebral ischemic events associated with stenting for symptomatic carotid stenosis. Methods: 127 patients who had been studied by diffusion-weighted MR imaging (DWI) before and on the day after carotid stenting were included. Six clinical variables and 5 variables characterizing the target carotid artery and aortic atherosclerosis were analyzed as potential risk factors for new ipsilateral DWI lesions after stenting. Results: Among all variables assessed, only age, length of stenosis and carotid intima-media thickness (IMT) significantly modified the risk of new lesions after stenting. Age ≧68 years, stenosis ≧15 mm and IMT ≧1.3 mm were identified as the best thresholds to predict new lesions. In the subgroup of patients ≧68 years with carotid stenosis ≧15 mm in length and IMT ≧1.3 mm, the risk of new lesions was markedly higher than in patients to whom no more than two of these factors applied (odds ratio 7.250, 95% CI 1.612–34.513, p = 0.005). The use of this simple predictive model correctly identified patients who had new lesions after stenting with high specificity (0.96) and a negative predictive value (0.83), while the positive predictive value was moderate (0.60) and sensitivity was low (0.23). Conclusions: The risk of stenting for symptomatic carotid stenosis may vary with clinical and morphological patient characteristics. Further research is needed to validate these results and to evaluate the safety of stenting versus endarterectomy in specific patient subgroups.

© 2011 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: July 01, 2011
Accepted: August 22, 2011
Published online: November 30, 2011
Issue release date: January 2012

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 3

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: http://www.karger.com/CED


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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