Neuroradiology

, Volume 52, Issue 4, pp 275–283

Magnetic resonance plaque imaging to predict the occurrence of the slow-flow phenomenon in carotid artery stenting procedures

Authors

    • Department of RadiologyNara Medical University
  • Toshiaki Taoka
    • Department of RadiologyNara Medical University
  • Hiroyuki Nakagawa
    • Department of RadiologyNara Medical University
  • Katsutoshi Takayama
    • Department of Interventional NeuroradiologyIshinkai Yao General Hospital
  • Takeshi Wada
    • Department of RadiologyNara Medical University
  • Kaoru Myouchin
    • Department of Interventional NeuroradiologyIshinkai Yao General Hospital
  • Toshiaki Akashi
    • Department of RadiologyNara Medical University
  • Toshiteru Miyasaka
    • Department of RadiologyNara Prefectural Nara Hospital
  • Akio Fukusumi
    • Department of RadiologyTakanohara Central Hospital
  • Satoru Iwasaki
    • Department of RadiologyHigashiosaka General Hospital
  • Kimihiko Kichikawa
    • Department of RadiologyNara Medical University
Diagnostic Neuroradiology

DOI: 10.1007/s00234-009-0623-7

Cite this article as:
Sakamoto, M., Taoka, T., Nakagawa, H. et al. Neuroradiology (2010) 52: 275. doi:10.1007/s00234-009-0623-7

Abstract

Introduction

The purpose is to investigate the feasibility of magnetic resonance (MR) plaque imaging in predicting the arterial flow impairment (slow-flow phenomenon) during carotid artery stenting (CAS) using a filter-type protection device.

Methods

Thirty-one carotid artery stenotic lesions in 30 patients (28 men and two women; mean age, 71.8 years) were evaluated by MR plaque imaging with black blood T1- and T2-weighted and time-of-flight sequences before CAS. Main plaque components were classified as vulnerable (intraplaque hemorrhage and lipid-rich/necrotic core) or stable (fibrous tissue and dense calcification) from the signal pattern. The plaque classification was statistically compared with the occurrence of slow-flow phenomenon.

Results

The slow-flow phenomenon was observed in ten CAS procedures (five flow arrests and five flow reductions). Flow arrests consisted of four vulnerable and one stable plaque, and flow reductions consisted of four vulnerable and one stable plaque. The slow-flow phenomenon occurred significantly (P < 0.01) more frequently in patients with vulnerable plaque.

Conclusions

Vulnerable carotid plaques have a significantly higher risk of slow-flow phenomenon than stable plaques. The occurrence of the slow-flow phenomenon can be predicted by MR plaque imaging before CAS.

Keywords

Carotid artery stentingMR plaque imageSlow-flow phenomenon

Copyright information

© Springer-Verlag 2009