Cardiovascular Surgery and Interventions 2021, Vol 8, Num 1 Page(s): 028-034
Evaluation of factors increasing the risk of silent brain infarction using multidetector computed tomography in patients undergoing carotid artery stenting

Hasan Onan1, Ferhat Pişkin1, Turgay Demir2, Hüseyin Ballı1

1Department of Radiology, Çukurova University Faculty of Medicine, Adana, Turkey
2Department of Neurology, Çukurova University Faculty of Medicine, Adana, Turkey

Keywords: Aortic arch, carotid stenting, computed tomography, plaque
Objectives: This study aims to identify the factors increasing the risk of silent brain infarction using multidetector computer tomography (MDCT) in patients undergoing carotid artery stenting (CAS).

Patients and methods: Medical data of a total of 24 patients (12 males, 12 females; mean age: 65.4±74 years; range, 50 to 76 years) who underwent CAS between December 2017 and July 2019 were retrospectively analyzed. The plaque characteristics of carotid arteries and the aortic arch structures were determined using MDCT before the procedure. The patients were divided into two groups based on the diffusion-weighted images after the procedure. Those with and without silent brain infarction were in Group 1 (n=10) and Group 2 (n=14), respectively. Both groups were compared in terms of aortic arch structures and the plaque characteristics.

Results: There was a significant difference between the groups in terms of plaque in the aortic arch (n=8 vs. n=5, respectively, p=0.047). The number of irregular plaque surfaces, plaque length, and plaque volume were significantly higher in Group 1 than Group 2 (8 vs. 5, respectively; p=0.047; 21.8 vs. 17.6, respectively; p=0.045, and 991.1 vs. 740.3, respectively; p=0.015). The percentages of lipid components in total plaque volume were significantly higher in Group 1 (p=0.026). The receiver operating characteristic analysis revealed that 17.8% of lipid components in total volume had 64.3% sensitivity and 90% specificity in the differentiation of the groups.

Conclusion: Evaluation of aortic arch structures and the plaque characteristics in carotid arteries using MDCT may be useful for predicting the risk of silent brain infarction after CAS.

DOI : 10.5606/e-cvsi.2021.1050