Impact of Stent-Assisted Recanalization of Carotid Artery Stenosis on Brain Volume Changes

Yıl 2016, Cilt: 7 Sayı: 4, 283 - 289, 01.12.2016

Ömer Fatih Nas , Aylin Bican Demir Mustafa Bakar Güven Özkaya Emre Kaçar Bahattin Hakyemez

https://doi.org/10.5799/jcei.328500

Öz

Objective: The purpose of this study was to investigate the effect of recanalization on stenotic internal carotid artery
on brain volume changes in stent applied patients.
Materials and Methods: Carotid stenting was performed in 17 patients with severe carotid artery stenosis between
June 2013 and April 2014. High resolution 3D T1 weight images were obtained from each patient 24 hours before
and 7.2 ± 3.6 months (mean ± standard deviation) after the procedure on a 3T magnetic resonance imaging scanner.
Intracranial total cortical grey matter, total cortical white matter, white matter hypointensity, total intraventricular and
subcortical grey matter volumes were assessed by FreeSurfer version 4.5.0.
Results: A significant reduction was found in total cortical white matter and subcortical grey matter volumes (p<0.05).
A significant increase was found in white matter hypointensity and total intraventricular volumes after procedure
(p<0.05). However, no statistical significant difference was found in total cortical grey matter volume before and after
procedure (p=0.902).
Conclusion: The significant reduction in the postoperative intracranial total cortical white matter and subcortical grey
matter volumes and the significant increase in the white matter hypointensity volume were considered to be
secondary to neuronal damage. J Clin Exp Invest 2016; 7(4): 283-289

Anahtar Kelimeler

Brain volume changes, carotid stenosis, magnetic resonance imaging

Kaynakça

• 1. Yun TJ, Sohn CH, Han MH, et al. Effect of carotid artery stenting on cerebral blood flow: evaluation of hemodynamic changes using arterial spin labeling. Neuroradiology 2013;55:271-81.
• 2. Tavares A, Caldas JG, Castro CC, et al. Changes in perfusion-weighted magnetic resonance imaging after carotid angioplasty with stent. Interv Neuroradiol 2010;16:161-69.
• 3. Clarkson MJ, Cardoso MJ, Ridgway GR, et al. A comparison of voxel and surface based cortical thickness Estimation methods. Neuroimage 2011;57:856-65.
• 4. Fischl B. FreeSurfer. Neuroimage. 2012;62:774-81.
• 5. Fox AJ. How to measure carotid stenosis. Radiology 1993;186:316-18.
• 6. Van Laar PJ, Hendrikse J, Mali WP, et al. Altered flow territories after carotid stenting and carotid endarterectomy. J Vasc Surg 2007;45:1155-61.
• 7. Ko NU, Achrol AS, Chopra M, et al. Cerebral blood flow changes after endovascular treatment of cerebrovascular stenoses. AJNR Am J Neuroradiol 2005;26:538-42.
• 8. Derdeyn CP, Videen TO, Fritsch SM, et al. Compensatory mechanisms for chronic cerebral hypoperfusion in patients with carotid occlusion. Stroke 1999;30:1019-24.
• 9. Norrving B, Nilsson B, Risberg J. rCBF in patients with carotid occlusion. Resting and hypercapnic flow related to collateral pattern. Stroke 1982;13:155-62.
• 10. Baron JC, Bousser MG, Rey A, et al. Reversal of focal "misery-perfusion syndrome" by extraintracranial arterial bypass in hemodynamic cerebral ischemia. A case study with 150 positron emission tomography. Stroke 1981;12:454-59.
• 11. Cheung RT. The utility of melatonin in reducing cerebral damage resulting from ischemia and reperfusion. J Pineal Res 2003;34:153-60.
• 12. Sastry PS, Rao KS. Apoptosis and the nervous system. J Neurochem 2000;74:1-20.
• 13. Chen J, Jin K, Chen M, et al. Early detection of DNA strand breaks in the brain after transient focal ischemia:İmplications for the role of DNA damage in apoptosis and neuronal cell death. J Neurochem 1997;69:232-45.
• 14. Pulsinelli WA, Brierley JB, Plum F. Temporal profile of neuronal damage in a model of transient forebrain ischemia. Ann Neurol. 1982;11:491-98.
• 15. Liem F, Mérillat S, Bezzola L, et al. Reliability and statistical power analysis of cortical and subcortical FreeSurfer metrics in a large sample of healthy elderly. Neuroimage 2015;108:95-109.