Incidence and risk factors for diffusion-weighted imaging (+) lesions after intracranial stenting and its relationship with symptomatic ischemic complications

Keun Young Park, Byungmoon Kim, Dong Joon Kim, Dong Ik Kim, Jihoe Heo, Hyo Suk Nam, Young Dae Kim, Dongbeom Song

Research output: Contribution to journalArticle

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Abstract

Background and Purpose-Little is known about high-signal lesions in magnetic resonance diffusion-weighted imaging (DWI [+]) after stenting for intracranial atherosclerotic stenosis. This study aimed to evaluate the incidence, distribution, risk factors, and clinical implications of DWI (+) after intracranial stenting. Methods-A total of 123 patients (male:female=88:35, mean age, 64.1 years) with symptomatic intracranial atherosclerotic stenosis (mean stenosis, 76.1±7.7%) underwent both stenting and poststenting DWI. The incidence, distribution (embolicalone versus stenosis-associated perforator/mixed), and risk factors of DWI (+) and its relationship with symptomatic ischemic complications (SIC, including stroke or transient ischemic attack) were retrospectively evaluated. Results-Forty-three patients (35.0%) had DWI (+). Middle cerebral artery, smaller distal parent artery, and treatmentrelated dissection were independent risk factors for DWI (+) (P<0.05). SIC occurred in 4 patients (3.3%), all of whom had DWI (+). Of the patients with DWI (+), neither the number nor the volume of DWI (+) differed significantly between SIC and asymptomatic patients: median number/patient, 3.5 (range, 2-11) versus 2.0 (range, 1-11) and median volume/ patient, 329.8 mm3 (range, 76-883.5 mm3) versus 119.5 mm3 (range, 32.5-873.0 mm3). However, SIC occurred more frequently in the stenosis-associated perforator/mixed type (3/11, 27.3%) than in the embolic-alone type (1/32, 3.1%; P<0.05). Conclusions-The incidence of DWI (+) after intracranial stenting for intracranial atherosclerotic stenosis was 35.0%. Middle cerebral artery, smaller distal parent artery, and treatment-related dissection were independent risk factors for DWI (+). SIC occurred more frequently in the stenosis-associated perforator/mixed type than in the embolic-alone type.

Original languageEnglish
Pages (from-to)3298-3303
Number of pages6
JournalStroke
Volume45
Issue number11
DOIs
Publication statusPublished - 2014 Jan 1

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Pathologic Constriction
Incidence
Middle Cerebral Artery
Dissection
Arteries
Diffusion Magnetic Resonance Imaging
Transient Ischemic Attack
Stroke

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

Cite this

Park, Keun Young ; Kim, Byungmoon ; Kim, Dong Joon ; Kim, Dong Ik ; Heo, Jihoe ; Nam, Hyo Suk ; Kim, Young Dae ; Song, Dongbeom. / Incidence and risk factors for diffusion-weighted imaging (+) lesions after intracranial stenting and its relationship with symptomatic ischemic complications. In: Stroke. 2014 ; Vol. 45, No. 11. pp. 3298-3303.
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title = "Incidence and risk factors for diffusion-weighted imaging (+) lesions after intracranial stenting and its relationship with symptomatic ischemic complications",
abstract = "Background and Purpose-Little is known about high-signal lesions in magnetic resonance diffusion-weighted imaging (DWI [+]) after stenting for intracranial atherosclerotic stenosis. This study aimed to evaluate the incidence, distribution, risk factors, and clinical implications of DWI (+) after intracranial stenting. Methods-A total of 123 patients (male:female=88:35, mean age, 64.1 years) with symptomatic intracranial atherosclerotic stenosis (mean stenosis, 76.1±7.7{\%}) underwent both stenting and poststenting DWI. The incidence, distribution (embolicalone versus stenosis-associated perforator/mixed), and risk factors of DWI (+) and its relationship with symptomatic ischemic complications (SIC, including stroke or transient ischemic attack) were retrospectively evaluated. Results-Forty-three patients (35.0{\%}) had DWI (+). Middle cerebral artery, smaller distal parent artery, and treatmentrelated dissection were independent risk factors for DWI (+) (P<0.05). SIC occurred in 4 patients (3.3{\%}), all of whom had DWI (+). Of the patients with DWI (+), neither the number nor the volume of DWI (+) differed significantly between SIC and asymptomatic patients: median number/patient, 3.5 (range, 2-11) versus 2.0 (range, 1-11) and median volume/ patient, 329.8 mm3 (range, 76-883.5 mm3) versus 119.5 mm3 (range, 32.5-873.0 mm3). However, SIC occurred more frequently in the stenosis-associated perforator/mixed type (3/11, 27.3{\%}) than in the embolic-alone type (1/32, 3.1{\%}; P<0.05). Conclusions-The incidence of DWI (+) after intracranial stenting for intracranial atherosclerotic stenosis was 35.0{\%}. Middle cerebral artery, smaller distal parent artery, and treatment-related dissection were independent risk factors for DWI (+). SIC occurred more frequently in the stenosis-associated perforator/mixed type than in the embolic-alone type.",
author = "Park, {Keun Young} and Byungmoon Kim and Kim, {Dong Joon} and Kim, {Dong Ik} and Jihoe Heo and Nam, {Hyo Suk} and Kim, {Young Dae} and Dongbeom Song",
year = "2014",
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doi = "10.1161/STROKEAHA.114.006182",
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Incidence and risk factors for diffusion-weighted imaging (+) lesions after intracranial stenting and its relationship with symptomatic ischemic complications. / Park, Keun Young; Kim, Byungmoon; Kim, Dong Joon; Kim, Dong Ik; Heo, Jihoe; Nam, Hyo Suk; Kim, Young Dae; Song, Dongbeom.

In: Stroke, Vol. 45, No. 11, 01.01.2014, p. 3298-3303.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Incidence and risk factors for diffusion-weighted imaging (+) lesions after intracranial stenting and its relationship with symptomatic ischemic complications

AU - Park, Keun Young

AU - Kim, Byungmoon

AU - Kim, Dong Joon

AU - Kim, Dong Ik

AU - Heo, Jihoe

AU - Nam, Hyo Suk

AU - Kim, Young Dae

AU - Song, Dongbeom

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background and Purpose-Little is known about high-signal lesions in magnetic resonance diffusion-weighted imaging (DWI [+]) after stenting for intracranial atherosclerotic stenosis. This study aimed to evaluate the incidence, distribution, risk factors, and clinical implications of DWI (+) after intracranial stenting. Methods-A total of 123 patients (male:female=88:35, mean age, 64.1 years) with symptomatic intracranial atherosclerotic stenosis (mean stenosis, 76.1±7.7%) underwent both stenting and poststenting DWI. The incidence, distribution (embolicalone versus stenosis-associated perforator/mixed), and risk factors of DWI (+) and its relationship with symptomatic ischemic complications (SIC, including stroke or transient ischemic attack) were retrospectively evaluated. Results-Forty-three patients (35.0%) had DWI (+). Middle cerebral artery, smaller distal parent artery, and treatmentrelated dissection were independent risk factors for DWI (+) (P<0.05). SIC occurred in 4 patients (3.3%), all of whom had DWI (+). Of the patients with DWI (+), neither the number nor the volume of DWI (+) differed significantly between SIC and asymptomatic patients: median number/patient, 3.5 (range, 2-11) versus 2.0 (range, 1-11) and median volume/ patient, 329.8 mm3 (range, 76-883.5 mm3) versus 119.5 mm3 (range, 32.5-873.0 mm3). However, SIC occurred more frequently in the stenosis-associated perforator/mixed type (3/11, 27.3%) than in the embolic-alone type (1/32, 3.1%; P<0.05). Conclusions-The incidence of DWI (+) after intracranial stenting for intracranial atherosclerotic stenosis was 35.0%. Middle cerebral artery, smaller distal parent artery, and treatment-related dissection were independent risk factors for DWI (+). SIC occurred more frequently in the stenosis-associated perforator/mixed type than in the embolic-alone type.

AB - Background and Purpose-Little is known about high-signal lesions in magnetic resonance diffusion-weighted imaging (DWI [+]) after stenting for intracranial atherosclerotic stenosis. This study aimed to evaluate the incidence, distribution, risk factors, and clinical implications of DWI (+) after intracranial stenting. Methods-A total of 123 patients (male:female=88:35, mean age, 64.1 years) with symptomatic intracranial atherosclerotic stenosis (mean stenosis, 76.1±7.7%) underwent both stenting and poststenting DWI. The incidence, distribution (embolicalone versus stenosis-associated perforator/mixed), and risk factors of DWI (+) and its relationship with symptomatic ischemic complications (SIC, including stroke or transient ischemic attack) were retrospectively evaluated. Results-Forty-three patients (35.0%) had DWI (+). Middle cerebral artery, smaller distal parent artery, and treatmentrelated dissection were independent risk factors for DWI (+) (P<0.05). SIC occurred in 4 patients (3.3%), all of whom had DWI (+). Of the patients with DWI (+), neither the number nor the volume of DWI (+) differed significantly between SIC and asymptomatic patients: median number/patient, 3.5 (range, 2-11) versus 2.0 (range, 1-11) and median volume/ patient, 329.8 mm3 (range, 76-883.5 mm3) versus 119.5 mm3 (range, 32.5-873.0 mm3). However, SIC occurred more frequently in the stenosis-associated perforator/mixed type (3/11, 27.3%) than in the embolic-alone type (1/32, 3.1%; P<0.05). Conclusions-The incidence of DWI (+) after intracranial stenting for intracranial atherosclerotic stenosis was 35.0%. Middle cerebral artery, smaller distal parent artery, and treatment-related dissection were independent risk factors for DWI (+). SIC occurred more frequently in the stenosis-associated perforator/mixed type than in the embolic-alone type.

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