, Volume 52, Issue 4, pp 275–283 | Cite as

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

  • Masahiko Sakamoto
  • Toshiaki Taoka
  • Hiroyuki Nakagawa
  • Katsutoshi Takayama
  • Takeshi Wada
  • Kaoru Myouchin
  • Toshiaki Akashi
  • Toshiteru Miyasaka
  • Akio Fukusumi
  • Satoru Iwasaki
  • Kimihiko Kichikawa
Diagnostic Neuroradiology



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.


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.


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.


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.


Carotid artery stenting MR plaque image Slow-flow phenomenon 


Conflict of interest statement

We declare that we have no conflict of interest.


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Masahiko Sakamoto
    • 1
  • Toshiaki Taoka
    • 1
  • Hiroyuki Nakagawa
    • 1
  • Katsutoshi Takayama
    • 2
  • Takeshi Wada
    • 1
  • Kaoru Myouchin
    • 2
  • Toshiaki Akashi
    • 1
  • Toshiteru Miyasaka
    • 3
  • Akio Fukusumi
    • 4
  • Satoru Iwasaki
    • 5
  • Kimihiko Kichikawa
    • 1
  1. 1.Department of RadiologyNara Medical UniversityNaraJapan
  2. 2.Department of Interventional NeuroradiologyIshinkai Yao General HospitalOsakaJapan
  3. 3.Department of RadiologyNara Prefectural Nara HospitalNaraJapan
  4. 4.Department of RadiologyTakanohara Central HospitalNaraJapan
  5. 5.Department of RadiologyHigashiosaka General HospitalOsakaJapan

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