Preprocedural Carotid Plaque Echolucency as a Predictor of In-Stent Intimal Restenosis after Carotid Artery Stenting
| Autor: | Toshihiro Ueda, Yasuhiro Hasegawa, Yoko Tsuchihashi, Noriko Usuki, Yuta Hagiwara, Satoshi Takaishi, Kentaro Tatsuno, Haruki Otsubo, Yoshihisa Yamano, Naoki Takao, Kaima Soga, Takahiro Shimizu, Tomohide Yoshie, Tatsuro Takada |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Intimal hyperplasia medicine.medical_treatment Carotid endarterectomy Risk Assessment Lesion 03 medical and health sciences 0302 clinical medicine Restenosis Predictive Value of Tests Recurrence Risk Factors Neointima medicine Humans Carotid Stenosis Aged Retrospective Studies Aged 80 and over Neointimal hyperplasia Ultrasonography Doppler Duplex medicine.diagnostic_test business.industry Angioplasty Rehabilitation Angiography Stent Middle Aged medicine.disease Magnetic Resonance Imaging Plaque Atherosclerotic Stenosis Carotid Arteries Treatment Outcome Female Stents Surgery Neurology (clinical) Radiology medicine.symptom Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Stroke and Cerebrovascular Diseases. 29:105339 |
| ISSN: | 1052-3057 |
| DOI: | 10.1016/j.jstrokecerebrovasdis.2020.105339 |
| Popis: | In-stent intimal restenosis (ISR) caused by neointimal hyperplasia can develop24 months after carotid artery stenting (CAS). The utility of plaque imaging by carotid ultrasonography (US) or magnetic resonance imaging (MRI) has been investigated for the prediction of ipsilateral stroke. We aimed to investigate whether these imaging techniques are useful for detecting carotid plaques prone to ISR.We examined 133 patients (mean age of 72.1 ± 8.4 years old) that received CAS at a single hospital from 2014 to 2018. A pre-CAS carotid plaque evaluation was performed by carotid angiography, duplex carotid US, and black-blood carotid artery MRI (BB-MRI). The mean stenosis rate was 71.0 ± 12.3% by the North American Symptomatic Carotid Endarterectomy Trial (NASCET) methods. Follow-up carotid angiography was performed 6 months after CAS in all patients according to a predefined protocol. ISR was defined as in-stent intimal hyperplasia more than 50% stenosed based on the NASCET criteria. The selection of the stent type was at the discretion of the treating physician. Predictors of ISR were determined by multivariate logistic regression analysis.Follow-up angiography demonstrated ISR in 33 patients (24.8%). In 44 patients, more than two stents were deployed. Univariate logistic regression analyses demonstrated echolucent lesion, floating plaque, complete occlusive or pseudo-occlusive lesion, and closed-cell stent use as significantly associated with ISR (50%). Multivariate logistic regression analysis demonstrated that echolucent lesion (OR 4.667, 95% CI 1.849-11.779) and closed-cell stent use (OR .378, 95% CI .148-.968) were significantly associated with ISR.Preprocedural plaque characterization by carotid US appeared to be useful to predict ISR 6 months after CAS. |
| Databáze: | OpenAIRE |
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