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Cerebral embolism during carotid artery stenting: role of carotid plaque echolucency.

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Cerebral embolism during carotid artery stenting: role of carotid plaque echolucency. / Rosenkranz, Michael; Wittkugel, Oliver; Waiblinger, Christian; Thomalla, Götz; Krutzelmann, Anna; Havemeister, Stefanie; Zeumer, Hermann; Gerloff, Christian; Fiehler, Jens.

In: CEREBROVASC DIS, Vol. 27, No. 5, 5, 01.01.2009, p. 443-449.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Rosenkranz, M, Wittkugel, O, Waiblinger, C, Thomalla, G, Krutzelmann, A, Havemeister, S, Zeumer, H, Gerloff, C & Fiehler, J 2009, 'Cerebral embolism during carotid artery stenting: role of carotid plaque echolucency.', CEREBROVASC DIS, vol. 27, no. 5, 5, pp. 443-449. https://doi.org/10.1159/000209239

APA

Rosenkranz, M., Wittkugel, O., Waiblinger, C., Thomalla, G., Krutzelmann, A., Havemeister, S., Zeumer, H., Gerloff, C., & Fiehler, J. (2009). Cerebral embolism during carotid artery stenting: role of carotid plaque echolucency. CEREBROVASC DIS, 27(5), 443-449. [5]. https://doi.org/10.1159/000209239

Vancouver

Rosenkranz M, Wittkugel O, Waiblinger C, Thomalla G, Krutzelmann A, Havemeister S et al. Cerebral embolism during carotid artery stenting: role of carotid plaque echolucency. CEREBROVASC DIS. 2009 Jan 1;27(5):443-449. 5. https://doi.org/10.1159/000209239

Bibtex

@article{591d06c6eed144bea692ca0973e6e17c,
title = "Cerebral embolism during carotid artery stenting: role of carotid plaque echolucency.",
abstract = "BACKGROUND: Carotid artery stenting (CAS) is associated with the risk of intraprocedural stroke. A better understanding of specific risk factors could help to improve the procedure and to reduce the overall risk of CAS. We addressed the role of carotid plaque echolucency as potential risk factor for cerebral embolism during CAS. METHODS: We prospectively evaluated carotid plaque echolucency by use of a computer-assisted measure of echogenicity, the gray scale median (GSM), in 31 consecutive patients with symptomatic high-grade carotid stenosis that were scheduled to undergo CAS. Dual-frequency transcranial Doppler ultrasound was used to detect solid cerebral microemboli during CAS. RESULTS: 27 of the 31 patients met all inclusion/exclusion criteria.Solid cerebral microemboli were detected during 17 of 27 CAS procedures. The GSM of the target plaques was lower in subjects with intraprocedural embolism (37.9 +/- 20.8) than in those without (58.2 +/- 25.7) (p = 0.040). A receiver-operating characteristic analysis showed that the GSM that gave the greatest separation between plaques with a higher and a lower probability of intraprocedural embolism was 50: the proportion of subjects with intraprocedural embolism was 85% in CAS of echolucent plaques (GSM or =50) (p = 0.031). CONCLUSIONS: CAS of both echolucent and echogenic carotid plaques may be associated with cerebral embolism, particularly CAS of echolucent plaques. Plaque echolucency alone does not reliably identify patients at particularly high risk of intraprocedural embolism, but should be considered as one of a broad panel of risk factors of CAS.",
keywords = "Aged, Carotid Arteries, Carotid Artery Diseases, Carotid Stenosis, Female, Humans, Image Processing, Computer-Assisted, Intracranial Embolism, Male, Middle Aged, Prospective Studies, Risk Factors, Stents, Ultrasonography, Doppler, Transcranial",
author = "Michael Rosenkranz and Oliver Wittkugel and Christian Waiblinger and G{\"o}tz Thomalla and Anna Krutzelmann and Stefanie Havemeister and Hermann Zeumer and Christian Gerloff and Jens Fiehler",
note = "Copyright 2009 S. Karger AG, Basel.",
year = "2009",
month = jan,
day = "1",
doi = "10.1159/000209239",
language = "English",
volume = "27",
pages = "443--449",
journal = "CEREBROVASC DIS",
issn = "1015-9770",
publisher = "S. Karger AG",
number = "5",

}

RIS

TY - JOUR

T1 - Cerebral embolism during carotid artery stenting: role of carotid plaque echolucency.

AU - Rosenkranz, Michael

AU - Wittkugel, Oliver

AU - Waiblinger, Christian

AU - Thomalla, Götz

AU - Krutzelmann, Anna

AU - Havemeister, Stefanie

AU - Zeumer, Hermann

AU - Gerloff, Christian

AU - Fiehler, Jens

N1 - Copyright 2009 S. Karger AG, Basel.

PY - 2009/1/1

Y1 - 2009/1/1

N2 - BACKGROUND: Carotid artery stenting (CAS) is associated with the risk of intraprocedural stroke. A better understanding of specific risk factors could help to improve the procedure and to reduce the overall risk of CAS. We addressed the role of carotid plaque echolucency as potential risk factor for cerebral embolism during CAS. METHODS: We prospectively evaluated carotid plaque echolucency by use of a computer-assisted measure of echogenicity, the gray scale median (GSM), in 31 consecutive patients with symptomatic high-grade carotid stenosis that were scheduled to undergo CAS. Dual-frequency transcranial Doppler ultrasound was used to detect solid cerebral microemboli during CAS. RESULTS: 27 of the 31 patients met all inclusion/exclusion criteria.Solid cerebral microemboli were detected during 17 of 27 CAS procedures. The GSM of the target plaques was lower in subjects with intraprocedural embolism (37.9 +/- 20.8) than in those without (58.2 +/- 25.7) (p = 0.040). A receiver-operating characteristic analysis showed that the GSM that gave the greatest separation between plaques with a higher and a lower probability of intraprocedural embolism was 50: the proportion of subjects with intraprocedural embolism was 85% in CAS of echolucent plaques (GSM or =50) (p = 0.031). CONCLUSIONS: CAS of both echolucent and echogenic carotid plaques may be associated with cerebral embolism, particularly CAS of echolucent plaques. Plaque echolucency alone does not reliably identify patients at particularly high risk of intraprocedural embolism, but should be considered as one of a broad panel of risk factors of CAS.

AB - BACKGROUND: Carotid artery stenting (CAS) is associated with the risk of intraprocedural stroke. A better understanding of specific risk factors could help to improve the procedure and to reduce the overall risk of CAS. We addressed the role of carotid plaque echolucency as potential risk factor for cerebral embolism during CAS. METHODS: We prospectively evaluated carotid plaque echolucency by use of a computer-assisted measure of echogenicity, the gray scale median (GSM), in 31 consecutive patients with symptomatic high-grade carotid stenosis that were scheduled to undergo CAS. Dual-frequency transcranial Doppler ultrasound was used to detect solid cerebral microemboli during CAS. RESULTS: 27 of the 31 patients met all inclusion/exclusion criteria.Solid cerebral microemboli were detected during 17 of 27 CAS procedures. The GSM of the target plaques was lower in subjects with intraprocedural embolism (37.9 +/- 20.8) than in those without (58.2 +/- 25.7) (p = 0.040). A receiver-operating characteristic analysis showed that the GSM that gave the greatest separation between plaques with a higher and a lower probability of intraprocedural embolism was 50: the proportion of subjects with intraprocedural embolism was 85% in CAS of echolucent plaques (GSM or =50) (p = 0.031). CONCLUSIONS: CAS of both echolucent and echogenic carotid plaques may be associated with cerebral embolism, particularly CAS of echolucent plaques. Plaque echolucency alone does not reliably identify patients at particularly high risk of intraprocedural embolism, but should be considered as one of a broad panel of risk factors of CAS.

KW - Aged

KW - Carotid Arteries

KW - Carotid Artery Diseases

KW - Carotid Stenosis

KW - Female

KW - Humans

KW - Image Processing, Computer-Assisted

KW - Intracranial Embolism

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Risk Factors

KW - Stents

KW - Ultrasonography, Doppler, Transcranial

U2 - 10.1159/000209239

DO - 10.1159/000209239

M3 - SCORING: Journal article

C2 - 19295207

VL - 27

SP - 443

EP - 449

JO - CEREBROVASC DIS

JF - CEREBROVASC DIS

SN - 1015-9770

IS - 5

M1 - 5

ER -