Kouichi Misaki1, Naoyuki Uchiyama2, Masanao Mohri2, Yutaka Hayashi2, Fumiaki Ueda3, Mitsutoshi Nakada2. 1. Kanazawa University, Graduate School of Medical Science, Division of Neuroscience, Department of Neurosurgery, 13-1 Takara-machi, Kanazawa, 920-8641 Ishikawa, Japan. Electronic address: misaki@med.kanazawa-u.ac.jp. 2. Kanazawa University, Graduate School of Medical Science, Division of Neuroscience, Department of Neurosurgery, 13-1 Takara-machi, Kanazawa, 920-8641 Ishikawa, Japan. 3. Kanazawa University, Graduate School of Medical Science, Division of Cardiovascular Medicine, Department of Radiology, 13-1 Takara-machi, Kanazawa, 920-8641 Ishikawa, Japan.
Abstract
BACKGROUND AND PURPOSE: To assess the relationship between plaque volume evaluated by multidetector computed tomographic angiography (MDCT) and in-stent restenosis (ISR) after carotid artery stenting (CAS). MATERIALS AND METHODS: From a retrospectively maintained database, data were collected for 52patients with carotid artery stenosis treated with CAS between 2007 and 2012. We defined ISR of≥50% as a peak systolic velocity≥200cm/s on echo-duplex scan. Carotid plaques were subdivided into four components according to radiodensity in Hounsfield units (HU) as follows: <0, 0-60, 60-130, and>600HU. Risk factors that influenced ISR were compared using univariate and multivariate Cox regression analyses. RESULTS: During a median follow-up period of 36months, ISR of≥50% was detected in five patients (9.6%). In the univariate Cox proportional hazard regression analysis, renal insufficiency, coronary artery disease, total plaque volume, and plaque volumes with radiodensities<0 and≥600HU increased the risk for ISR (P<0.10). When the significant risk factors determined from the univariate analysis were subjected to a multivariate analysis, only the volumes of the plaque components with radiodensities<0 HU independently predicted the development of ISR (hazard ratio: 1.041; 95% confidence interval: 1.006-1.078; P=0.021). CONCLUSION: Our data suggest that the high volume of the plaque components with radiodensities<0HU was independently associated with the increased risk of ISR after CAS. Quantitative and qualitative tissue characterizations of carotid plaques using MDCT might be a useful predictive tool of the development of ISR.
BACKGROUND AND PURPOSE: To assess the relationship between plaque volume evaluated by multidetector computed tomographic angiography (MDCT) and in-stent restenosis (ISR) after carotid artery stenting (CAS). MATERIALS AND METHODS: From a retrospectively maintained database, data were collected for 52patients with carotid artery stenosis treated with CAS between 2007 and 2012. We defined ISR of≥50% as a peak systolic velocity≥200cm/s on echo-duplex scan. Carotid plaques were subdivided into four components according to radiodensity in Hounsfield units (HU) as follows: <0, 0-60, 60-130, and>600HU. Risk factors that influenced ISR were compared using univariate and multivariate Cox regression analyses. RESULTS: During a median follow-up period of 36months, ISR of≥50% was detected in five patients (9.6%). In the univariate Cox proportional hazard regression analysis, renal insufficiency, coronary artery disease, total plaque volume, and plaque volumes with radiodensities<0 and≥600HU increased the risk for ISR (P<0.10). When the significant risk factors determined from the univariate analysis were subjected to a multivariate analysis, only the volumes of the plaque components with radiodensities<0 HU independently predicted the development of ISR (hazard ratio: 1.041; 95% confidence interval: 1.006-1.078; P=0.021). CONCLUSION: Our data suggest that the high volume of the plaque components with radiodensities<0HU was independently associated with the increased risk of ISR after CAS. Quantitative and qualitative tissue characterizations of carotid plaques using MDCT might be a useful predictive tool of the development of ISR.
Authors: Francesco Stilo; Nunzio Montelione; Rosalinda Calandrelli; Marisa Distefano; Francesco Spinelli; Vincenzo Di Lazzaro; Fabio Pilato Journal: Ann Transl Med Date: 2020-10