Can carotid ultrasound predict neurological risk after carotid intervention?

Ideggyogy Sz. 2023 Mar 30;76(3-4):95-101. doi: 10.18071/isz.76.0095.

Abstract
in English, Hungarian

Background and purpose: <p>&nbsp;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 pur&shy;pose of our study is to find the most efficient carotid ultrasound method to forecast peri&shy;pro&shy;cedural risk (embolization, new neu&shy;ro&shy;logical symptoms). &nbsp;</p>.

Methods: <p>We used Pubmed, EMBASE, and the Cochrane Library to conduct a sys&shy;te&shy;ma&shy;tic literature search for the years 2000 to 2022.</p>.

Results: <p>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 &le; 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. &nbsp;</p>.

Conclusion: <p>A future, large-scale, multi-center study should confirm which grayscale medium value is optimal to forecast periprocedural ischemic complications.</p>.

<p style="text-align: justify;"><strong>H&aacute;tt&eacute;r &eacute;s c&eacute;l </strong>&ndash; Mind a carotisstent (CAS), mind a carotisendarterectomia (CEA) alkalmazhat&oacute; a carotisszűk&uuml;let &aacute;ltal okozott ischaemi&aacute;s stroke megelőz&eacute;s&eacute;re, de mindk&eacute;t beavatkoz&aacute;s komplik&aacute;ci&oacute;kkal&nbsp;j&aacute;rhat. C&eacute;lunk annak meg&aacute;llapít&aacute;sa, melyik carotis&shy;-ultrahang-m&oacute;dszer a legalkalmasabb a beavatkoz&aacute;shoz kapcsol&oacute;d&oacute; sz&ouml;vődm&eacute;nyek előrejelz&eacute;s&eacute;re (embolisatio, &uacute;j neurol&oacute;giai t&uuml;netek). <strong>M&oacute;dszerek</strong> &ndash; A&nbsp;PubMed, az EMBASE &eacute;s a Cochrane&nbsp;adatb&aacute;zisokban 2000-től 2022-ig megjelent k&ouml;zlem&eacute;nyek elemz&eacute;se.&nbsp; <br><strong>Eredm&eacute;nyek</strong> &ndash; A plakk grayscale-median(GSM-) &eacute;rt&eacute;ke a leg&eacute;rz&eacute;kenyebb m&oacute;dszer a periproceduralis&nbsp;sz&ouml;vődm&eacute;nyek j&oacute;sl&aacute;s&aacute;ra. A viszonylag kis l&eacute;tsz&aacute;m&uacute; vizsg&aacute;latok szerint a &le; 20 GSM-&eacute;rt&eacute;kek m&aacute;r jelentős &nbsp;periproceduralis sz&ouml;vődm&eacute;nyvesz&eacute;lyre utalnak. Megbesz&eacute;l&eacute;s &ndash; A diff&uacute;zi&oacute;s&uacute;lyozott MR a leg&eacute;rz&eacute;kenyebb m&oacute;dszer&nbsp;annak eld&ouml;nt&eacute;s&eacute;re, hogy a CEA vagy a stent okozott-e ischaemi&aacute;s sz&ouml;vődm&eacute;nyt. <br><strong>K&ouml;vetkeztet&eacute;s</strong> &ndash; Nagy l&eacute;tsz&aacute;m&uacute;, multicentrikus vizsg&aacute;latnak kell eld&ouml;ntenie, melyik GSM-&eacute;rt&eacute;k az optim&aacute;lis a periproceduralis komplik&aacute;ci&oacute;k előrejelz&eacute;s&eacute;re.</p>.

Keywords: carotid artery stenting; carotid endarterectomy; carotid ultrasound; grayscale median; ischemic stroke.

Publication types

  • Review

MeSH terms

  • Carotid Stenosis* / complications
  • Carotid Stenosis* / diagnostic imaging
  • Carotid Stenosis* / surgery
  • Diffusion Magnetic Resonance Imaging
  • Humans
  • Risk Factors
  • Stents / adverse effects
  • Stroke* / diagnosis
  • Stroke* / etiology
  • Stroke* / prevention & control
  • Treatment Outcome
  • Ultrasonography, Carotid Arteries