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Research ArticlePatient Safety
Open Access

Safety of Protected Carotid Artery Stenting in Patients with Severe Carotid Artery Stenosis and Carotid Intraplaque Hemorrhage

W. Yoon, S.K. Kim, M.S. Park, H.J. Chae and H.K. Kang
American Journal of Neuroradiology June 2012, 33 (6) 1027-1031; DOI: https://doi.org/10.3174/ajnr.A2911
W. Yoon
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S.K. Kim
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M.S. Park
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H.J. Chae
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H.K. Kang
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    Fig 1.

    An example of intraplaque hemorrhage seen on a TOF source image in a 71-year-old man with a left cerebral ischemic event. A, Axial source image of TOF MRA shows the IPH (short arrows) in the eccentric left carotid plaque, which surrounds the lumen of the internal carotid artery with severe stenosis. IPH is identified as a hyperintense signal intensity compared with the adjacent neck muscle. B, Lateral projection of a left carotid angiogram shows long segmental severe stenosis in the proximal cervical portion of the left internal carotid artery. C, Postcarotid artery stent placement angiogram shows minimal residual stenosis at the origin site of the left internal carotid artery.

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    Table 1:

    Baseline characteristics of the study population

    No IPH (n = 48; 61.5%)IPH (n = 30; 38.5%)P
    Age (years)71 ± 770 ± 70.880
    Sex, male41 (85.4%)28 (93.3%)0.469
    Index event
        TIA8 (16.7%)4 (13.3%)0.758
        Ischemic stroke12 (25%)16 (53.3%)0.011
        TIA or ischemic stroke20 (41.7%)20 (66.7%)0.032
    Cerebrovascular history
        Previous ischemic stroke11 (22.9%)7 (23.3%)0.966
        History of ischemic heart disease13 (27.1%)8 (26.7%)0.968
    Cerebrovascular risk factors
        Hypertension34 (70.8%)24 (80%)0.367
        Diabetes mellitus21 (43.8%)12 (40%)0.744
        Dyslipidemia9 (18.8%)10 (33.3%)0.144
        Atrial fibrillation6 (12.5%)1 (3.3%)0.240
        Smoking24 (50%)17 (56.7%)0.566
    • Note:—Data are means ± SD or number of patients (%).

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    Table 2:

    Thirty-day clinical outcomes after protected carotid artery stenting

    No IPH (n = 48; 61.5%)IPH (n = 30; 38.5%)P
    Hyperperfusion syndrome1 (2.1%)2 (6.7%)0.555
    Minor stroke2 (4.2%)2 (6.7%)0.636
    Major stroke00–
    MI01 (3.3%)0.385
    Death1 (2.1%)1 (3.3%)1.000
    Stroke or MI or death3 (6.25%)3 (10%)0.670
    • Note:—Data are numbers of patients (%).

    • View popup
    Table 3:

    Incidence of clinical outcome according to the presence or absence of patient symptoms before CAS

    Symptomatic (n = 40; 51.7%)Asymptomatic (n = 38; 48.3%)
    IPH (n = 20)No IPH (n = 20)IPH (n = 10)No IPH (n = 28)
    Hyperperfusion syndrome2100
    Minor stroke2101
    Major stroke0000
    MI1000
    Death1100
    Stroke or MI or death3201
    • Note:—Data are numbers of patients.

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American Journal of Neuroradiology: 33 (6)
American Journal of Neuroradiology
Vol. 33, Issue 6
1 Jun 2012
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Cite this article
W. Yoon, S.K. Kim, M.S. Park, H.J. Chae, H.K. Kang
Safety of Protected Carotid Artery Stenting in Patients with Severe Carotid Artery Stenosis and Carotid Intraplaque Hemorrhage
American Journal of Neuroradiology Jun 2012, 33 (6) 1027-1031; DOI: 10.3174/ajnr.A2911

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Safety of Protected Carotid Artery Stenting in Patients with Severe Carotid Artery Stenosis and Carotid Intraplaque Hemorrhage
W. Yoon, S.K. Kim, M.S. Park, H.J. Chae, H.K. Kang
American Journal of Neuroradiology Jun 2012, 33 (6) 1027-1031; DOI: 10.3174/ajnr.A2911
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Cited By...

  • The association between carotid intraplaque hemorrhage and outcomes of carotid stenting: a systematic review and meta-analysis
  • Carotid artery stenting for vulnerable plaques on MR angiography and ultrasonography: utility of dual protection and blood aspiration method
  • Associations between Cerebral Embolism and Carotid Intraplaque Hemorrhage during Protected Carotid Artery Stenting
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