Prediction of Long-Term Restenosis After Carotid Endarterectomy Using Quantitative Magnetic Resonance Angiography.

Andereggen, Lukas; Amin-Hanjani, Sepideh; Beck, Jürgen; Luedi, Markus M; Gralla, Jan; Schubert, Gerrit A; Tortora, Angelo; Andres, Robert H; Arnold, Marcel; Raabe, Andreas; Reinert, Michael (2022). Prediction of Long-Term Restenosis After Carotid Endarterectomy Using Quantitative Magnetic Resonance Angiography. Frontiers in neurology, 13(862809), p. 862809. Frontiers Media S.A. 10.3389/fneur.2022.862809

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Background

To detect restenosis after carotid endarterectomy (CEA), long-term monitoring is required. However, non-selective follow-up is controversial and can be limited by costs and logistical considerations.

Objective

To examine the value of immediate perioperative vessel flow measurements after CEA using quantitative magnetic resonance angiography (QMRA) to detect patients at risk of long-term restenosis.

Methods

A prospective cohort study with long-term sonographic follow-up after CEA for symptomatic internal carotid artery stenosis (ICAs) > 50%. In all patients, vessel flow has been assessed both pre- and postoperatively using QMRA within ±3 days of surgery. Data on QMRA assessment were analyzed to identify patients at risk of restenosis for up to 10 years.

Results

Restenosis was recorded in 4 of 24 patients (17%) at a median follow-up of 6.8 ± 2.6 years. None of them experienced an ischemic event. Perioperative flow differences were significantly greater in patients without long-term restenosis, both for the ipsilateral ICA (p < 0.001) and MCA (p = 0.03), compared to those with restenosis (p = 0.22 and p = 0.3, respectively). The ICA mean flow ratio (p = 0.05) tended to be more effective than the MCA ratio in predicting restenosis over the long term (p = 0.35).

Conclusion

Our preliminary findings suggest that QMRA-based mean flow increases after CEA may be predictive of restenosis over the long term. Perioperative QMRA assessment could become an operator-independent screening tool to identify a subgroup of patients at risk for restenosis, in whom long-term monitoring is advised.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Forschungsbereich Mu50 > Forschungsgruppe Neurochirurgie

UniBE Contributor:

Andereggen, Lukas, Beck, Jürgen, Lüdi, Markus, Gralla, Jan, Andres, Robert, Arnold, Marcel, Raabe, Andreas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1664-2295

Publisher:

Frontiers Media S.A.

Language:

English

Submitter:

Pubmed Import

Date Deposited:

20 Jul 2022 11:40

Last Modified:

05 Dec 2022 16:21

Publisher DOI:

10.3389/fneur.2022.862809

PubMed ID:

35847222

Uncontrolled Keywords:

carotid artery stenosis carotid endarterectomy cerebral blood flow quantitative phase-contrast MR angiography restenosis

BORIS DOI:

10.48350/171410

URI:

https://boris.unibe.ch/id/eprint/171410

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