Factors Associated With Silent Brain Infarcts After Middle Cerebral Artery Stenting or Balloon Angioplasty

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY Journal of Neuroimaging Pub Date : 2025-02-03 DOI:10.1111/jon.70018

Kyubong Lee, Jeong Yoon Song, Hyunsun Oh, Taewoo Kim, Jun Young Chang, Dong-Wha Kang, Sun U. Kwon, Seon Moon Hwang, Joon Ho Choi, Boseong Kwon, Yunsun Song, Deok Hee Lee, Bum Joon Kim

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Abstract

Background and Purpose

Silent brain infarcts (SBIs), which manifest as dot-like lesions on diffusion-weighted imaging (DWI) after endovascular procedures, are associated with an increased risk of stroke, dementia, and cognitive decline. We aimed to identify the factors associated with SBIs following middle cerebral artery (MCA) stenting or balloon angioplasty.

Methods

We retrospectively reviewed patients who underwent MCA stenting or balloon angioplasty, including those with symptomatic, atherosclerotic MCA stenosis of ≥50%. DWI scans were conducted before and after the procedure, and newly detected DWI lesions were classified as SBIs. We investigated the factors associated with the development of SBIs, and for patients with SBIs, we conducted a detailed analysis based on lesion location (cortex and perforator territory vs. cortex only vs. perforator territory only).

Results

Among 120 patients, 64 (53.3%) exhibited SBIs postprocedure. Factors significantly associated with SBIs included smaller stenosis diameter (odd ratio [95% confidence interval] = 0.03 [0.002–0.35], p = 0.006), longer stenosis length (1.24 [1.02–1.51], p = 0.033), higher MCA tortuosity (1.20 [1.07–1.34], p = 0.002), and diffuse involvement of MCA stenosis (3.99 [1.17–13.62], p = 0.027). Among the patients who exhibited SBIs, D-dimer (p = 0.002), C-reactive protein (p = 0.026), and hemoglobin A1c (p = 0.025) differed according to detailed mechanism.

Conclusions

Stenosis diameter, stenosis length, and MCA tortuosity were significantly associated with the development of SBIs following MCA stenting.

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来源期刊

Journal of Neuroimaging 医学-核医学

CiteScore

4.70

自引率

0.00%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!