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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
New Diffusion Abnormalities Following Endovascular Treatment for Intracranial Atherosclerosis
Zhikai Hou1, Jing Jing1, Long Yan1
1From the Department of Interventional Neuroradiology (Z.H., L.Y., W.F., Y.Y., L.J., J.Y., Z.M., N.M.), Department of Neurosurgery (Z.H.), Tiantan Neuroimaging Center of Excellence (J.J., Z.Z., Y.W.), and Department of Neurology (J.J., J.L., Y.W.), Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing 100070, China; China National Clinical Research Center for Neurologic Diseases, Beijing, China (Z.H., J.J., L.Y., Z.Z., W.F., J.L., Y.Y., L.J., J.Y., Y.W., Z.M., N.M.); and Department of Radiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China (X.L.).
New ischemic brain lesions are common after endovascular treatment for intracranial atherosclerotic stenosis. Cigarette smoking and multiple operative attempts predict these lesions, highlighting areas for improved patient care.
Area of Science:
- Neurology
- Radiology
- Interventional Cardiology
Background:
- Limited data exist on new ischemic brain lesions following endovascular treatment for symptomatic intracranial atherosclerotic stenosis (ICAS).
- Understanding lesion characteristics and predictors is crucial for optimizing treatment strategies.
Purpose of the Study:
- To characterize new ischemic brain lesions on diffusion-weighted MRI after endovascular treatment for ICAS.
- To compare lesion characteristics between balloon angioplasty and stent placement.
- To identify predictors of new ischemic brain lesions.
Main Methods:
- Prospective enrollment of 119 patients with symptomatic ICAS undergoing endovascular treatment.
- Thin-section diffusion-weighted MRI performed before and after treatment.
- Multivariable logistic regression analysis to determine predictors of new lesions.
Main Results:
- 65% of patients (77/119) developed new ischemic brain lesions.
- Lesions were frequently located in or beyond the treated artery's territory (61% and 35%, respectively).
- Cigarette smoking (OR, 3.6) and multiple operative attempts (OR, 2.9) were independent predictors.
Conclusions:
- New ischemic brain lesions are frequent after endovascular treatment for ICAS.
- Occurrence is associated with cigarette smoking and increased operative attempts.
- Findings suggest potential targets for risk reduction and improved outcomes.
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