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Ischemic cerebral lesions after carotid surgery and carotid stenting

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journal contribution
posted on 2007-04-01, 00:00 authored by V Lacroix, F Hammer, P Astarci, T Duprez, C Grandin, G Cosnard, Anna PeetersAnna Peeters, R Verhelst
Objectives
To evaluate the risk of new ischemic cerebral lesions after carotid endarterectomy and carotid stenting and their clinical significance.

Methods
Prospective and non-randomized single-center study including 121 patients with symptomatic and asymptomatic significant carotid stenosis. 60 patients were treated by surgery and 61 treated by carotid stenting. Stenting was restricted to patients at high risk for surgery. Neurological examination and Diffusion-Weighted Cerebral Magnetic Resonance (DW-MRI) were performed before and after each procedure. The presence, location and volume of new cerebral lesions were determined.

Results
In the surgical group, 2 minor strokes were registered. DW-MRI showed new lesions in 7 patients (11.6%). All except one were located in the ipsilateral anterior circulation.

In the stenting group, 1 minor stroke and 1 occurrence of quadranopsia were registered. DW-MRI showed new lesions in 26 patients (42.6%). 10 of these patients (38.4%) had lesions in the contralateral hemisphere and 7 patients (26.9%) in the posterior circulation.

Deficits are found in patients with higher lesion volumes.

Conclusions
Cerebral ischemic lesions are significantly (p < 0.0001) more frequent after carotid stenting than after endarterectomy. The majority of these lesions have no immediate clinical implication, but more specific tests are needed to evaluate their exact significance.

History

Journal

European journal of vascular and endovascular surgery

Volume

33

Issue

4

Pagination

430 - 435

Publisher

Elsevier

Location

Amsterdam, The Netherlands

ISSN

1078-5884

Language

English

Publication classification

C1.1 Refereed article in a scholarly journal

Copyright notice

2006, Elsevier Ltd.

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