Lesion load in unprotected carotid artery stenting

Introduction The purpose of the study was to determine the incidence of new ischemic lesions found on diffusion weighted MR imaging (DWI) in non selected patients after unprotected carotid artery stent placement. Materials and methods We retrospectively reviewed a nonrandomized cohort of 197 patients presenting with carotid occlusive disease who underwent unprotected carotid artery stent placement between 2003 and 2006. Mean degree of stenosis was 86.94%±9.72. In all patients, DWI was obtained before and 24 h after stent placement. New lesions were evaluated according to size and location. Results In 59 of 197 patients (29.9%), new ischemic lesions were found on DWI in the vessel dependent area. In 23 of 197 patients (11.7%), new ischemic lesions were found in the vessel independent area. Combined stroke/death rate was 3.63%. Conclusion In our series of unprotected carotid angioplasty with stent, we found new DWI lesions in 34% of the patients. Further studies should now show in how far protection devices can reduce these lesions.