Early Improvement in Interstitial Fluid Flow in Patients With Severe Carotid Stenosis After Angioplasty and Stenting.

IF 6 1区医学 Q1 CLINICAL NEUROLOGY Journal of Stroke Pub Date : 2024-09-01 Epub Date: 2024-08-30 DOI:10.5853/jos.2023.04203

Chia-Hung Wu, Shih-Pin Chen, Chih-Ping Chung, Kai-Wei Yu, Te-Ming Lin, Chao-Bao Luo, Jiing-Feng Lirng, I-Hui Lee, Feng-Chi Chang

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Abstract

Background and purpose: This study aimed to investigate early changes in interstitial fluid (ISF) flow in patients with severe carotid stenosis after carotid angioplasty and stenting (CAS).

Methods: We prospectively recruited participants with carotid stenosis ≥80% undergoing CAS at our institute between October 2019 and March 2023. Magnetic resonance imaging (MRI), including diffusion tensor imaging (DTI), and the Mini-Mental State Examination (MMSE) were performed 3 days before CAS. MRI with DTI and MMSE were conducted within 24 hours and 2 months after CAS, respectively. The diffusion tensor image analysis along the perivascular space (DTI-ALPS) index was calculated from the DTI data to determine the ISF status. Increments were defined as the ratio of the difference between post- and preprocedural values to preprocedural values.

Results: In total, 102 participants (age: 67.1±8.9 years; stenosis: 89.5%±5.7%) with longitudinal data were evaluated. The DTI-ALPS index increased after CAS (0.85±0.15; 0.85 [0.22] vs. 0.86±0.14; 0.86 [0.21]; P=0.022), as did the MMSE score (25.9±3.7; 24.0 [4.0] vs. 26.9±3.4; 26.0 [3.0]; P<0.001). Positive correlations between increments in the DTI-ALPS index and MMSE score were found in all patients (rs=0.468; P<0.001).

Conclusion: An increased 24-hour post-CAS DTI-ALPS index suggests early improvement in ISF flow efficiency. The positive correlation between the 24-hour DTI-ALPS index and 2-month MMSE score increments suggests that early ISF flow improvement may contribute to long-term cognitive improvement after CAS.

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血管成形术和支架植入术后严重颈动脉狭窄患者间质流的早期改善。

背景和目的：本研究旨在探讨颈动脉血管成形术和支架植入术（CAS）后重度颈动脉狭窄患者间质流（ISF）的早期变化：我们前瞻性地招募了2019年10月至2023年3月期间在我院接受CAS手术的颈动脉狭窄≥80%的患者。CAS术前3天进行磁共振成像（MRI），包括弥散张量成像（DTI）和迷你精神状态检查（MMSE）。CAS 后 24 小时内和 2 个月内分别进行了 MRI 与 DTI 和 MMSE 检查。根据 DTI 数据计算出沿血管周围空间的弥散张量图像分析（DTI-ALPS）指数，以确定 ISF 状态。增量被定义为手术后与手术前数值之差与手术前数值之比：共评估了102名参与者（年龄：67.1±8.9岁；狭窄程度：89.5%±5.7%）的纵向数据。CAS术后DTI-ALPS指数增加（0.85±0.15；0.85 [0.22] vs. 0.86±0.14；0.86 [0.21]；P=0.022），MMSE评分也增加（25.9±3.7；24.0 [4.0] vs. 26.9±3.4；26.0 [3.0]；P=0.022）。

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来源期刊

Journal of Stroke CLINICAL NEUROLOGYPERIPHERAL VASCULAR DISE-PERIPHERAL VASCULAR DISEASE

CiteScore

11.00

自引率

3.70%

发文量

审稿时长

12 weeks

期刊介绍： The Journal of Stroke (JoS) is a peer-reviewed publication that focuses on clinical and basic investigation of cerebral circulation and associated diseases in stroke-related fields. Its aim is to enhance patient management, education, clinical or experimental research, and professionalism. The journal covers various areas of stroke research, including pathophysiology, risk factors, symptomatology, imaging, treatment, and rehabilitation. Basic science research is included when it provides clinically relevant information. The JoS is particularly interested in studies that highlight characteristics of stroke in the Asian population, as they are underrepresented in the literature. The JoS had an impact factor of 8.2 in 2022 and aims to provide high-quality research papers to readers while maintaining a strong reputation. It is published three times a year, on the last day of January, May, and September. The online version of the journal is considered the main version as it includes all available content. Supplementary issues are occasionally published. The journal is indexed in various databases, including SCI(E), Pubmed, PubMed Central, Scopus, KoreaMed, Komci, Synapse, Science Central, Google Scholar, and DOI/Crossref. It is also the official journal of the Korean Stroke Society since 1999, with the abbreviated title J Stroke.