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Novel 3D-CT evaluation of carotid stent volume: greater chronological expansion of stents in patients with vulnerable plaques

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

Although self-expanding carotid stents may dilate gradually, the degrees of residual stenosis have been quantified by the NASCET criteria, which is too simple to reflect the configuration of the stented artery. We measured the volumes of the stent lumens chronologically by 3D-CT in patients after carotid artery stenting (CAS), and analyzed the correlations between the volume change and medical factors.

Methods

Fourteen patients with carotid artery stenosis were treated using self-expanding, open-cell stents. All patients underwent preoperative plaque MRI (magnetization-prepared rapid acquisition gradient-echo, MPRAGE) and chronological 3D-CT examinations of their stents immediately after their placement and 1 day, 1 week, and 1 month after the procedure. The volume of the stent lumen was measured using a 3D workstation. The correlations between stent volume and various factors including the presence of underlying diseases, plaque characteristics, and the results of the CAS procedure were analyzed.

Results

Stent volume gradually increased in each case and had increased by 1.04–1.55 (mean, 1.25)-fold at 1 postoperative month. The presence of underlying medical diseases, plaque length, the degree of residual stenosis immediately after CAS, and plaque calcification did not have an impact on the change in stent volume. On the other hand, the stent volume increase was significantly larger in the patients with vulnerable plaques that demonstrated high MPRAGE signal intensity (P < 0.05).

Conclusions

A 3D-CT examination is useful for precisely measuring stent volume. Self-expanding stents in carotid arteries containing vulnerable plaques expand significantly more than those without such plaques in a follow-up period.

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Abbreviations

CAS:

Carotid artery stenting

CI:

Confidence interval

HU:

Hounsfield unit

ICC:

Intraclass correlation coefficients

MPRAGE:

Magnetization-prepared rapid acquisition gradient-echo

NASCET:

North American Symptomatic Carotid Endarterectomy Trial

WW/WL:

Window width and window level

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Acknowledgements

This research was supported by SENSHIN Medical Research Foundation, 2010 (no applicable grant number). Portions of this work were presented in abstract form at the 10th Meeting of Asian Australasian Federation of Interventional and Therapeutic Neuroradiology, Nagoya, Japan, June 14, 2012.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan

    Hisakazu Itami, Koji Tokunaga, Yu Okuma, Tomohito Hishikawa, Kenji Sugiu & Isao Date

  2. Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan

    Kentaro Ida

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  1. Hisakazu Itami
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  2. Koji Tokunaga
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  3. Yu Okuma
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  4. Tomohito Hishikawa
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  5. Kenji Sugiu
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  6. Kentaro Ida
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  7. Isao Date
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Correspondence to Koji Tokunaga.

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Itami, H., Tokunaga, K., Okuma, Y. et al. Novel 3D-CT evaluation of carotid stent volume: greater chronological expansion of stents in patients with vulnerable plaques. Neuroradiology 55, 1153–1160 (2013). https://doi.org/10.1007/s00234-013-1223-0

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  • DOI: https://doi.org/10.1007/s00234-013-1223-0

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