Evaluation of ischemic lesions after carotid artery stenting with diffusion-weighted imaging

Table 1 Gender distribution, clinical appearance and average stenosis rate in patients with carotid artery stenosis

Characteristic		n	%
Gender	Female	17	26.6
	Male	47	73.4
Clinical appearance	Asymptomatic	12	18.8
	Symptomatic	52	81.2
Average stenosis rate	Asymptomatic	-	68.33
	Symptomatic	-	74.69

Table 2 Accompanying comorbid diseases and risk factors for cases with carotid artery stenosis

Comorbid diseases and risk factors	n	%
Hypertension	38	30.2
Diabetes mellitus	22	17.5
Cerebrovascular disease	20	15.9
Coronary artery disease	15	11.9
Hyperlipidemia	9	7.1
Smoking	8	6.3
Goiter	5	4.0
Chronic obstructive pulmonary disease	4	3.2
Congestive heart failure	2	1.6
Asthma	1	0.8
Glaucoma	1	0.8
Familial mediterranean fever	1	0.8

Table 3 Side and location of carotid artery stenosis and distribution of atherosclerotic plaque morphology

Parameters		n	%
Side of stenosis	Right	33	51.6
	Left	31	48.4
Location of stenosis	CCA distal and ICA bulb	6	9.3
	ICA bulb	42	65.6
	Dissection of ICA bulb	1	1.6
	Distal of ICA bulb	4	6.3
	ICA bulb origin	3	4.6
	Proximal of ICA bulb	2	3.1
	Post-bulbar ICA and bulb	1	1.6
	Petrous ICA	1	1.6
	Post-bulbar ICA	4	6.3
Plaque morphology	Short segment regular surfaced	4	6.3
	Short segment irregular surfaced	2	3.2
	Short segment ulcerated	2	3.2
	Long segment regular surfaced	19	30.1
	Long segment irregular surfaced	12	19.1
	Long segment ulcerated	24	38.1

CCA: Common carotid artery; ICA: Internal carotid artery.

Table 4 Location and distribution by vascular territories of ischemic lesions which developed after carotid artery stenting based on diffusion-weighted imaging

Parameters	n	%
Location of cerebral parenchymal lesion
Occipital lobe	11	28.2
Frontal lobe	10	25.6
Parietal lobe	8	20.5
Basal ganglions	3	7.7
Cerebellum	2	5.1
Frontoparietal	1	2.6
Parietooccipital	1	2.6
Frontoparietooccipital	1	2.6
Occipitotemporoparietal	1	2.6
Corpus callosum	1	2.6
Cerebral vascular territory
MCA	15	38.5
PCA	8	20.5
MCA-PCA “watershed”	7	17.9
ACA	3	7.7
ACA-MCA “watershed”	2	5.1
ACA-MCA and MCA-PCA “watershed”	2	5.1
PICA	1	2.6
SCA	1	2.6

MCA: Middle cerebral artery; PCA: Posterior cerebral artery; ACA: Anterior cerebral artery; PICA: Posterior inferior cerebellar artery; SCA: Superior cerebellar artery.

Table 5 Technical properties, ischemic lesion numbers and complications in carotid artery stenting procedures

Case No.	Age	Gender	Stenosis localization	Balloon angioplasty	Embolic protection device	Ipsilateral lesion	Contralateral lesion	Complication
3	59	M	L ICA bulb	+	+	5	-	Silent ischemia
6	71	M	L ICA bulb	+	+	1	-	Silent ischemia
8	72	M	L ICA bulb	+	+	3	-	Silent ischemia
9	71	F	L ICA bulb	+	+	2	-	Silent ischemia
11	78	M	L ICA bulb	-	+	3	-	Silent ischemia
13	72	M	L ICA distal to bulb	+	+	1	-	Symptomatic ischemia
15	71	M	R ICA bulb	+	+	1	-	Silent ischemia
16	62	F	L ICA bulb	+	+	4	3	Silent ischemia
17	75	F	R ICA bulb	+	+	-	1	Silent ischemia
19	68	M	L post-bulbar ICA	+	+	2	-	Silent ischemia
23	67	M	R ICA bulb	+	+	1	-	Silent ischemia
26	84	M	L ICA bulb	+	+	-	1	Symptomatic ischemia
29	76	M	L post-bulbar ICA	+	+	1	-	Symptomatic ischemia
36	70	F	R ICA bulb	+	+	-	1	Silent ischemia
38	76	M	R ICA bulb	+	+	1	-	Silent ischemia
46	74	M	L ICA bulb	+	+	3	-	Silent ischemia
52	68	F	R ICA bulb	+	+	1	-	Symptomatic ischemia
54	72	F	R ICA bulb	+	+	2	-	Silent ischemia
58	67	M	R ICA bulb	+	+	1	-	Silent ischemia
59	67	M	L ICA bulb	+	+	1	-	Symptomatic ischemia

M: Male; F: Female; R: Right; L: Left; ICA: Internal carotid artery.

Table 6 Time to symptom development, neurological symptoms and prognosis in symptomatic patients after carotid artery stenting

Case No.	Time to symptom development	Neurological symptoms	Prognosis
13	1st hour	Loss of upper limb strength, right lower limb hemiparesis	Right upper limb muscle strength 4/5
26	5th hour	Restlessness, agitation	Recovery without sequelae
29	19th hour	Motor aphasia, right upper limb muscle strength 2/5, plegia of right leg	Right upper limb muscle strength 4/5, dysdiadochokinesia
52	22nd hour	Hemiparesis	Recovery without sequelae
59	24th hour	Cloudy vision, vertigo, ataxia	Recovery without sequelae