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Incidence and Risk Factors for Diffusion-Weighted Imaging (+) Lesions After Intracranial Stenting and Its Relationship With Symptomatic Ischemic Complications

Authors
 Keun Young Park  ;  Byung Moon Kim  ;  Dong Joon Kim  ;  Dong Ik Kim  ;  Ji Hoe Heo  ;  Hyo Suk Nam  ;  Young Dae Kim  ;  Dongbeom Song 
Citation
 STROKE, Vol.45(11) : 3298-3303, 2014 
Journal Title
 STROKE 
ISSN
 0039-2499 
Issue Date
2014
MeSH
Aged ; Brain Ischemia/diagnosis* ; Brain Ischemia/epidemiology* ; Diffusion Magnetic Resonance Imaging/adverse effects* ; Female ; Humans ; Incidence ; Intracranial Arteriosclerosis/diagnosis* ; Intracranial Arteriosclerosis/epidemiology* ; Intracranial Arteriosclerosis/surgery ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Stents/adverse effects*
Keywords
diffusion magnetic resonance imaging ; intracranial atherosclerosis ; stents ; stroke
Abstract
BACKGROUND AND PURPOSE: Little is known about high-signal lesions in magnetic resonance diffusion-weighted imaging (DWI [+]) after stenting for intracranial atherosclerotic stenosis. This study aimed to evaluate the incidence, distribution, risk factors, and clinical implications of DWI (+) after intracranial stenting. METHODS: A total of 123 patients (male:female=88:35, mean age, 64.1 years) with symptomatic intracranial atherosclerotic stenosis (mean stenosis, 76.1±7.7%) underwent both stenting and poststenting DWI. The incidence, distribution (embolic-alone versus stenosis-associated perforator/mixed), and risk factors of DWI (+) and its relationship with symptomatic ischemic complications (SIC, including stroke or transient ischemic attack) were retrospectively evaluated. RESULTS: Forty-three patients (35.0%) had DWI (+). Middle cerebral artery, smaller distal parent artery, and treatment-related dissection were independent risk factors for DWI (+) (P<0.05). SIC occurred in 4 patients (3.3%), all of whom had DWI (+). Of the patients with DWI (+), neither the number nor the volume of DWI (+) differed significantly between SIC and asymptomatic patients: median number/patient, 3.5 (range, 2-11) versus 2.0 (range, 1-11) and median volume/patient, 329.8 mm(3) (range, 76-883.5 mm(3)) versus 119.5 mm(3) (range, 32.5-873.0 mm(3)). However, SIC occurred more frequently in the stenosis-associated perforator/mixed type (3/11, 27.3%) than in the embolic-alone type (1/32, 3.1%; P<0.05). CONCLUSIONS: The incidence of DWI (+) after intracranial stenting for intracranial atherosclerotic stenosis was 35.0%. Middle cerebral artery, smaller distal parent artery, and treatment-related dissection were independent risk factors for DWI (+). SIC occurred more frequently in the stenosis-associated perforator/mixed type than in the embolic-alone type.
Full Text
http://stroke.ahajournals.org/content/45/11/3298.long
DOI
10.1161/STROKEAHA.114.006182
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Ik(김동익)
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Park, Keun Young(박근영)
Song, Dong Beom(송동범)
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100309
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