Carotid Stenosis Clinical Trial
Official title:
Correlation Between Cerebral Microembolisation and Plaque Characteristics After Carotid Revascularization
Microembolisation identified on diffusion-weighted magnetic resonance imaging (DW-MRI) is
recognized as an important outcome measure for carotid revascularization procedures such as
carotid stenting (CAS) or carotid endarterectomy (CEA). In fact, cerebral microembolisation
occurring during revascularization procedures is associated with an increased risk of peri-
and post-procedural stroke, transient ischemic attack as well as neurocognitive decline.
Carotid artery stenting is a less invasive alternative to endarterectomy to treat symptomatic
or asymptomatic carotid stenosis. Large randomized clinical trials showed a higher
periprocedural risk of non-disabling stroke with CAS and a higher periprocedural risk of
myocardial infarction, cranial nerve palsy, and access site hematoma with CEA.
However little is known regarding the correlation between the morphological characteristics
of the carotid plaque and the occurrence of microembolisation during the procedure and
between microembolisation and midterm cognitive impairment. A few studies suggest that plaque
morphology may be an important determinant for the increased risk of microembolisation. These
studies however have mainly investigated microembolisation occurring during CAS and
exploratory studies comparing the two procedures are still lacking.
The purpose of the present study is to determine the correlation between the morphological
characteristics of the carotid plaque and cerebral microembolisation either after carotid
stenting or after carotid endarterectomy in patients with symptomatic or asymptomatic carotid
disease.
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