You'll want to know this if you are having a carotid procedure, I'm glad my carotid is totally closed up, although you don't see that as a solution to carotid problems.
Systematic Review of Radiographic and Symptomatic Brain Infarcts in Carotid Artery Interventions and Cerebral Angiography
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Neurology April 5, 2016 vol. 86 no. 16 Supplement P1.230
- Abstract
Abstract
Objective:
To describe the rates of radiographic brain
infarcts and clinical strokes in cerebral and carotid procedures.
Introduction:
Reports vary in incidence of silent brain infarcts
after cerebrovascular procedures. In a systematic review we compared
rates
of radiographic brain infarcts (RBI) and clinical
strokes in cerebral and carotid procedures: diagnostic cerebral
angiography,
carotid endarterectomy (CEA), and carotid stenting
(CAS).
Methods: We searched MEDLINE and 4 other databases
for subject headings and text related to brain infarcts in carotid
artery
interventions from inception through February 2015.
We included articles with cerebral angiography and carotid
interventions
if brain MRI was performed systematically, RBI and
stroke incidence were reported.
Results: Of 6332 articles retrieved, 77 studies
(7296 patients) met the inclusion criteria. There were 12 cohorts in
cerebral
angiography, 26 in CEA, 39 in CAS with distal
protection, 8 in CAS with proximal protection with or without flow
reversal,
10 in CAS with unspecified devices and 10 in CAS
without protection. MRI diffusion-weighted imaging scan was performed
pre-procedure
in 75 studies and post-procedure in all studies.
The incidence of RBI and strokes in cerebral angiography were 20[percnt]
(262/1314) and 1.4[percnt] (18/1314). CEA had lower
incidence of RBI compared to CAS (15.9[percnt] (239/1524) vs
34.0[percnt]
(1522/4482), p<0.001) but not of strokes
(2.5[percnt] (37/1500) vs 3.4[percnt] (154/4482), p=0.07). Across the
procedures,
one out of 9.7 RBIs were symptomatic. RBI
incidences differed among embolism protection methods in CAS:
24.3[percnt] (70/288)
in proximal protection, 35.7[percnt] (740/2075) in
distal protection, 32.6[percnt] (489/1502) in unspecified devices, and
36.1[percnt] (223/617) without protection;
incidence of stroke were not significantly different among the
procedures with
2.4[percnt] (7/288), 3.3[percnt] (69/2075),
3.1[percnt] (46/1502), and 5.2[percnt] (32/617), respectively.
Conclusion: Only 1 of 10 periprocedural RBI during
carotid revascularization or diagnostic angiography were symptomatic.
CEA
has a lower incidence of RBI compared to CAS.
