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Non-enhanced magnetic resonance angiography can evaluate restenosis after carotid artery stenting with the Carotid Wallstent

  • Clinical Article - Vascular
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Abstract

Background

Carotid artery stenting (CAS) requires follow-up imaging to assess in-stent restenosis (ISR). This study aimed to determine whether non-enhanced magnetic resonance angiography (NE-MRA) is useful for evaluating ISR.

Method

Between 2009 and 2013, we performed 118 consecutive CAS procedures using the Precise stent (n = 78) and the Carotid Wallstent (n = 40). We reviewed 1.5 T NE-MRA and examined visualization of the stent lumen and the degree of ISR if present. Other imaging modalities were used as references.

Results

NE-MRA performed just after CAS was not able to visualize the stent lumen in all patients because of metal artifacts. In the Carotid Wallstent group, follow-up NE-MRA was available in 22 patients. The stent lumen was visible more than three months after CAS in all patients. Among them, >40 % ISR was observed by other modalities in eight lesions. The degree of restenosis measured by NE-MRA (y%) had a linear relationship with that measured by conventional angiography (x%) (y = 0.97x-0.4, r = 0.79, P = 0.021). In one case among 17 without ISR (6 %), NE-MRA showed false ISR. In the Precise stent group, NE-MRA did not visualize the stent lumen in the follow-up period.

Conclusions

NE-MRA can visualize the stent lumen in the Carotid Wallstent more than three months after CAS, but not in the Precise stent at follow-up. This delayed visualization might depend on endothelialization of the stent lumen. The degree of ISR measured by NE-MRA is comparable to that by conventional angiography. NE-MRA can evaluate ISR after CAS with the Carotid Wallstent (100 % sensitivity and 94 % specificity).

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Authors and Affiliations

  1. Department of Neurosurgery, Wakayama Rosai Hospital, 93-1 Kinomoto, Wakayama, 640-8505, Japan

    Kenichi Kono, Aki Shintani & Tomoaki Terada

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  1. Kenichi Kono
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  2. Aki Shintani
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  3. Tomoaki Terada
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Correspondence to Kenichi Kono.

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Kono, K., Shintani, A. & Terada, T. Non-enhanced magnetic resonance angiography can evaluate restenosis after carotid artery stenting with the Carotid Wallstent. Acta Neurochir 156, 1713–1719 (2014). https://doi.org/10.1007/s00701-014-2142-5

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  • DOI: https://doi.org/10.1007/s00701-014-2142-5

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