Prediction of cerebral ischemia during carotid stenting depending on the intensity of the preoperative ultrasound signal from the plaque

Carotid stenting is an effective method for improving cerebral perfusion; risk assessment of embolism associated with this intervention remains a hot research topic. Objective : to identify predictors carotid angioplasty (CAS). Material and methods . A prospective exploratory included 46 patients (age from 44 81 years, median 65 years) atherosclerotic stenosis the internal artery, who underwent CAS were treated at Scientific Center Neurology (Moscow). The study did not include restenosis, stroke severe disability, contraindications antiplatelet therapy, statins, MRI examination. All preoperative ultrasonographic (US) examination postoperative histological particles in stent embolic protection devices. state brain was assessed before 24 hours after using diffusion-weighted MRI. To development embolism, clinical characteristics patients, together morphological data, examined multivariate statistical analysis. Results Preoperative US signal plaque high (estimated above 35 dB) intensity dense matter (in protective device) "fibrosis calcification" "calcification" type probability (80%; 95% confidence interval 71–85% ) predicted intraoperative embolization vessels acute ischemic lesions (AIL) formation. In low (not higher than ultrasound signal, AIL formation statistically significantly lower (50%). Conclusion There direct correlation between density substance device. unfavorable predictor AIL, (with about 80%).