Complex aortic arch configurations and internal carotid artery (ICA) tortuosity were bad news for carotid artery stenting, but not endarterectomy, according to an MRI substudy of the International Carotid Stenting Study (ICSS).
New ischemic brain lesions on diffusion-weighted MRI after treatment were found in 51% of cases after stenting and 16% of cases after surgery (OR 6.0, 95% CI 2.9-12.4), the paper in the May 2017 issue of Stroke showed.
With carotid artery stenting, Leo Bonati, MD, of University Hospital Basel in Switzerland, and colleagues found age-independent predictors for new brain lesions to be aortic arch configuration type 2 or 3 (OR 2.8, 95% CI 1.1-7.1) and an ICA angle of 60º or higher (OR 4.1, 95% CI 1.7-10.1).
Those whose largest ICA angle was at least 60º had a 12-fold higher risk of strokes during stenting over their peers with smaller ICA angles (OR 11.8, 95% CI 4.1-34.1).
Read More: https://www.medpagetoday.com/cardiology/atherosclerosis/64568
Via: MedPage Today