LAUSR

BACKGROUND Silent cerebral embolism with carotid artery stenting (CAS) may contribute to dementia and cognitive decline. Moreover, clinically silent embolism is an important index of peri-procedural stroke risk. AIMS The purpose of this study was to compare the periprocedural asymptomatic cerebral embolism rates of CAS procedures performed for noncalcified and calcified carotid artery plaques using diffusion-weighted magnetic resonance imaging (DW-MRI). METHODS 570 clinically uncomplicated patients who underwent CAS at our center from December 2010 to June 2020 (mean [SD] age 69.3 [8.2]) were analyzed retrospectively. The patients were divided into 2 groups as noncalcified (268 patients) and calcified (302 patients) plague groups. Cerebral DW-MRI was performed for the patients before and after CAS and compared. Presence of periprocedural new ipsilateral diffusion limitations detected on cerebral DW-MRI were noted as a significant finding. İpsilateral diffusion limitations of the non-calcified and calcified plaque groups detected on cerebral DW-MRI were compared. RESULTS The presence of periprocedural asymptomatic ipsilateral DW-MRI lesions was higher patients in the noncalcified plaque group (45 [16.8%]) than in and patients in the calcified plaque group (31 [10.3%]), P = 0.02. CONCLUSION This study demonstrated that the rate of ipsilateral asymptomatic cerebral embolism detected on cerebral DW-MRI was higher in the CAS procedures performed for noncalcified carotid artery plaques than in the ones performed for calcified plaques.