Can carotid ultrasound predict neurological risk after carotid intervention?

Pub Date : 2023-03-30 DOI:10.18071/isz.76.0095

Chen Yi-Chun, Oláh László, Csiba László

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Abstract

Background and purpose:

To prevent ischemic strokes caused by carotid artery stenosis, carotid artery stenting (CAS) and carotid endarterectomy (CEA) have been utilized. However, complications could be linked to either or both procedures. The purpose of our study is to find the most efficient carotid ultrasound method to forecast periprocedural risk (embolization, new neurological symptoms). 

Methods:

We used Pubmed, EMBASE, and the Cochrane Library to conduct a systematic literature search for the years 2000 to 2022.

Results:

The grayscale medium (GSM) scale of plaque is the most promising criterion for evaluating periprocedural complications. According to the published observations (relatively small cohorts), peri-procedural problems would be significantly predicted by ≤ 20 of grayscale medium cut-off values. The diffusion-weighted MRI (DW-MRI) is the most sensitive method for assessing whether stenting or carotid endarterectomy resulted in peri-procedural ischemic lesions on diffusion-weighted MRI. 

Conclusion:

A future, large-scale, multi-center study should confirm which grayscale medium  value is optimal to forecast periprocedural ischemic complications.

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颈动脉超声能否预测颈动脉介入治疗后的神经风险?

背景与目的:为了预防颈动脉狭窄引起的缺血性卒中，颈动脉支架植入术(CAS)和颈动脉内膜切除术(CEA)已被应用。然而，并发症可能与任何一种或两种手术有关。我们研究的目的是寻找最有效的颈动脉超声方法来预测硬脑膜周围和周围的风险(栓塞、新出现的逻辑性症状)  方法:利用Pubmed、EMBASE和Cochrane图书馆对2000 - 2022年的文献进行系统检索。结果: 灰度中等(GSM)等级 是评估围手术期 并发症 最有希望的 标准。根据已发表的观察结果(相对较小的队列)，通过≤20的灰度中截止值。弥散加权MRI (DW-MRI)是 评估支架植入或颈动脉内膜切除术是否导致术中缺血 病变最敏感的 方法。  结论: 未来的、大规模的、 多中心的 研究应确认 哪种灰度中值 是预测围手术期缺血性并发症的最佳值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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