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Updated: May 11, 2026
A New Murine Model of Endovascular Aortic Aneurysm Repair
Published on: July 7, 2013
Pathway plaques and diffusion-weighted lesion analysis after endovascular treatment of unruptured intracranial
Qianmei Jiang1,2, Jing Jing1,2, Zhu Hao3
1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Objectives:
To evaluate the prevalence and predictors of ischemic lesions on thin-slice DWI (2 mm) in endovascular treatments for unruptured intracranial aneurysms (UIA), particularly explore the potential relationship with pathway plaques.
Methods:
Participants eligible for endovascular treatments with UIA at a national stroke center between March 2023 and August 2023 were prospectively enrolled. All participants performed thin-slice DWI (slice thickness of 2 mm) before and after procedures. Three-dimensional joint intra-and extracranial vessel wall MRI (3D-vwMRI, voxel size 0.6 × 0.6 × 0.6 mm3) was scheduled to evaluate the pathway plaques for all participants. The DWI-positive numbers were ordered and divided into four equal parts, with each quartile representing 25% of the data set.
Results:
A total of 106 participants were included. Overall, none of the participants exhibited preoperative DWI-positive lesions. Following the intervention, 93.4% (99/106) of participants exhibited new DWI-positive lesions on postoperative MRI, including 5.7% (6/106) with symptomatic ischemic stroke. Compared with the lowest quartile of ischemic lesions, the highest quartile was associated with increased odds of the presence of plaque (OR = 9.4, 95% CI: 2.0-45.4; p = 0.005). The history of previous stroke (OR = 4.6, 95% CI: 1.6-14.6; p = 0.007) and the presence of plaque in the pathway (OR = 3.4, 95% CI: 1.6-7.7; p = 0.002) were identified as independent predictors of higher quartiles of DWI-positive numbers.
Conclusions:
As revealed by thin-slice DWI, ischemic lesions related to the endovascular treatments for UIA occurred more frequently than anticipated. A history of the previous stroke and the pathway plaques were independent predictors of higher quartiles of DWI-positive numbers.
Key Points:
Question Previous studies using conventional MRI may underestimate DWI-positive lesions. The procedural risk of UIA coexisting with atherosclerotic plaques is still unclear. Findings Thin-slice DWI showed ischemic lesions occurred frequently (93.4%). Three-dimensional-intra-and extracranial Vessel Wall MRI revealed a positive correlation between pathway plaques and DWI lesions. Clinical relevance Neuro-interventionalists should exercise caution when managing patients with a history of previous stroke in the presence of plaques in the treatment pathway. More vigilant pre-procedural imaging should be considered to assess unstable plaque in high-risk patients.
