Background Plaque protrusion (PP) is sometimes detected by angiography or intravascular ultrasound (IVUS) during carotid artery stenting (CAS). However, the incidence and prognosis of PP are unclear. Purpose: We investigated the incidence and prognosis of PP during CAS.
Material and Methods We retrospectively analyzed the case of 292 patients with 308 carotid artery stenoses (252 men; age: 39–97 years [mean: 73.4 years]; symptomatic stenosis: 137 lesions; mean stenosis rate: 78.4%) who underwent CAS and preoperative MR plaque imaging from October 2007 to October 2015. The incidence of plaque protrusion was evaluated by IVUS and angiography. The 30 day prognosis of PP and the incidence of ischemic lesions within 48 h after CAS were assessed using diffusion-weighted images. All CAS was performed using the standard procedure and embolic protection devices.
Result PP occurred in eight patients (2.6%). Stroke occurred in four patients (major: 1, minor: 3) (50.0%) in the PP groups. New ischemic lesions were observed in 87.5% (7/8) of the PP group. There were siginificant difference in the frequencies of stroke and ischemic lesions between the PP group and non-PP group. The detection of unstable plaque on MR plaque imaging and the use of open cell stent were significant predictive factors of PP.
Conclusion PP during CAS is strongly associated with ischemic complications. PP prevention is necessary to avoid ischemic complications during CAS.
Disclosures K. Takayama: 2; C; Medtronic. K. Myouchin: None. T. Wada: None. M. Kotsugi: None. S. Kurokawa: None. K. Kichikawa: None.
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