Magnetic resonance plaque imaging to predict the occurrence of the slow-flow phenomenon in carotid artery stenting procedures

Masahiko Sakamoto, Toshiaki Taoka, Hiroyuki Nakagawa, Katsutoshi Takayama, Takeshi Wada, Kaoru Myouchin, Toshiaki Akashi, Toshiteru Miyasaka, Akio Fukusumi, Satoru Iwasaki, Kimihiko Kichikawa

Research output: Contribution to journalArticlepeer-review

23 Citations (Scopus)

Abstract

Introduction The purpose is to investigate the feasibility of magnetic resonance (MR) plaque imaging in predicting the marterial flow impairment (slow-flow phenomenon) during carotid artery stenting (CAS) using a filter-type protection device. Methods Thirty-one carotid artery stenotic lesions in 30 patients (28 men and two women; mean age, 71.8 years) were evaluated by MR plaque imaging with black blood T1- and T2-weighted and time-of-flight sequences before CAS. Main plaque components were classified as vulnerable (intraplaque hemorrhage and lipid-rich/necrotic core) or stable (fibrous tissue and dense calcification) from the signal pattern. The plaque classification was statistically compared with the occurrence of slow-flow phenomenon. Results The slow-flow phenomenon was observed in ten CAS procedures (five flow arrests and five flow reductions). Flow arrests consisted of four vulnerable and one stable plaque, and flow reductions consisted of four vulnerable and one stable plaque. The slow-flow phenomenon occurred significantly (P<0.01) more frequently in patients with vulnerable plaque. Conclusions Vulnerable carotid plaques have a significantly higher risk of slow-flow phenomenon than stable plaques. The occurrence of the slow-flow phenomenon can be predicted by MR plaque imaging before CAS

Original languageEnglish
Pages (from-to)275-283
Number of pages9
JournalNeuroradiology
Volume52
Issue number4
DOIs
Publication statusPublished - 2010 Apr 1

Keywords

  • Carotid artery stenting
  • MRplaque image
  • Slowflow phenomenon

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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