NDLI: Selection of carotid artery stenting or endarterectomy based on magnetic resonance plaque imaging reduced periprocedural adverse events.

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Selection of carotid artery stenting or endarterectomy based on magnetic resonance plaque imaging reduced periprocedural adverse events.

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Selection of carotid artery stenting or endarterectomy based on magnetic resonance plaque imaging reduced periprocedural adverse events.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Yoshimura, Shinichi Yamada, Kiyofumi Kawasaki, Masanori Asano, Takahiko Kanematsu, Masayuki Miyai, Masafumi Enomoto, Yukiko Egashira, Yusuke Iwama, Toru
Description	Author Affiliation: Yoshimura S ( Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan. Electronic address: shinichiyoshimura@hotmail.com.)
Abstract	BACKGROUND: The aim of this study was to elucidate the impact of treatment selection, either carotid stenting or endarterectomy, based on preoperative magnetic resonance (MR) plaque imaging on periprocedural events. METHODS: A total of 205 consecutive patients with high-grade carotid artery stenosis scheduled for elective revascularization with stenting or endarterectomy were retrospectively analyzed. In period 1, 95 patients were treated regardless of preoperative plaque imaging. In period 2, 110 patients received time of flight MR angiography, and endarterectomy was selected when a high-intensity signal in the plaque was observed on MR angiography because it indicated an unstable plaque. Periprocedural clinical results and outcome at 30 days were analyzed. RESULTS: In period 1, 5 patients (5.3%) were treated with endarterectomy and the other 90 patients (94.7%) were treated with stenting. In period 2, 35 patients (31.8%) were treated with endarterectomy and the other 75 patients (68.2%) were treated with stenting. Periprocedural adverse events, including any stroke, myocardial infarction, or death, were significantly more frequent in period 1 than in period 2 (9.5% v 1.8%; P = .034). Ischemic stroke was significantly reduced from period 1 to period 2 (7.4% v 0.9%; P = .043). Multivariate logistic regression analysis revealed 'treatment selection by plaque imaging' was the only factor identified as an independent predictor of periprocedural events (P = .043). CONCLUSIONS: Treatment selection based on preoperative plaque imaging appears useful for reducing periprocedural events of carotid artery revascularizations.
File Format	HTM / HTML
ISSN	10523057
Issue Number	7
Volume Number	22
e-ISSN	15328511
Journal	Journal of Stroke and Cerebrovascular Diseases
Language	English
Publisher	Elsevier
Publisher Date	2013-10-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Research Support, Non-u.s. Gov't Adverse Effects Humans Middle Aged Magnetic Resonance Angiography Male Treatment Outcome Plaque, Atherosclerotic Aged, 80 And Over Journal Article Radiography Endarterectomy, Carotid Discipline Cardiology Surgery Female Carotid Stenosis Aged Retrospective Studies Stents Methods
Content Type	Text
Resource Type	Article
Subject	Rehabilitation Neurology (clinical) Surgery Cardiology and Cardiovascular Medicine

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