Abstract
Introduction. Hyperintensive signals detected by diffusion weighted imaging (DWI) demonstrate cerebral ischemia with high accuracy. Ischemia during carotid endarterectomy (CEA) is mainly caused by microembolism. It was the aim of our study to evaluate the frequency, clinical significance, and course of ischemic lesions after CEA using serial DWI. Material and methods. This prospective study included 88 patients. DWI was performed within 1 day before and after CEA. Postoperative lesions were analyzed based on their quantity, volume, and distribution. To differentiate temporary ischemia from definite cerebral infarction (blood-brain barrier disruption), all patients with a positive post-operative DWI were reexamined with contrast-enhanced T1-MRI 7-10 days after the procedure. Results. Neurological deficit occurred in two (2.3%) patients. Ipsilateral ischemic lesions were detected with DWI in 15 (17%) patients. In seven of these patients, a brain infarction was diagnosed on the T1-MRI during follow-up. The number of DWI lesions (p=0.031) as well as the volume of DWI lesions (p=0.023) corresponded significantly with definite brain infarction. Patients preoperatively symptomatic showed significantly more DWI lesions (p=0.036) and cerebral infarcts (p=0.003). Conclusion. DWI is an effective method to demonstrate ischemic events after CEA. The number and volume of DWI lesions after CEA are highly predictive parameters for the risk of brain infarction. CEA in symptomatic carotid artery disease is correlated with a significantly higher risk of developing cerebral ischemia or cerebral infarction.
| Translated title of the contribution | Microembolization after carotid thrombendarterectomy - Analysis of cerebral ischemias with diffusion weighted imaging |
|---|---|
| Original language | German |
| Pages (from-to) | S29-S34 |
| Journal | Gefasschirurgie |
| Volume | 8 |
| Issue number | SUPPL. 1 |
| DOIs | |
| State | Published - Nov 2003 |
| Externally published | Yes |