Trial reportJournal of the American College of Cardiology2015
Ischemic brain lesions after carotid artery stenting increase future cerebrovascular risk.
Trial report in Journal of the American College of Cardiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03303430 (Correlation Between Cerebral Microembolisation and Plaque Characteristics After Carotid Revascularization), which is not on this map. Cited by 45 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Correlation Between Cerebral Microembolisation and Plaque Characteristics After Carotid Revascularization
Who cites it
45 citing papers in PubMed.
- Long-Term Stroke Risk in Patients With New Ischemic Brain Lesions on MRI After Carotid Revascularization.Stroke · 2023Trial
- Casper vs. Closed-Cell Stent : Carotid Artery Stenting Randomized Trial.Clinical neuroradiology · 2021Trial
- Early Diffusion-Weighted Imaging Lesions and Clinical Outcomes after Carotid Artery Stenting in Symptomatic Patients: A Single-Center Retrospective Study.Neurointervention · 2026Article
- Drug response testing for elective carotid artery stenting: Prevalence of non-response to aspirin and clopidogrel and influence on post-interventional occurrence of cerebral ischemia.The neuroradiology journal · 2026Article
- Cerebral DWI lesion burden following carotid artery stenting with guided antiplatelet therapy: a retrospective comparative study.CVIR endovascular · 2026Article
- The Utility of Antiplatelet Assay-Guided Individualized Dual Antiplatelet Therapy in Carotid Artery Stenting for Unstable Plaques.Journal of Korean Neurosurgical Society · 2026Article
- Stent Retriever-Assisted Embolic Protection During Recanalization of Chronic Internal Carotid Artery Occlusion with Contralateral Carotid Stenosis: A Case Report.Vascular health and risk management · 2026Article
- Comparative evaluation of the CGuard dual-layer stent and Carotid Wallstent for elective carotid artery stenting: a retrospective multicenter study.Neuroradiology · 2025Article
- Association of Plaque Characteristics With New Ischemic Lesions After Carotid Artery Stenting.CNS neuroscience & therapeutics · 2025Article
- Antithrombotic Therapy in Carotid Artery and Intracranial Artery Stent.Journal of neuroendovascular therapy · 2025Review
- Intraprocedural and Delayed Plaque Protrusion in Carotid Artery Stenting Using a Dual-Layer Metallic Stent.Journal of the Society for Cardiovascular Angiography & Interventions · 2024Article
- Current Status of Carotid Artery Stenting.Interventional radiology (Higashimatsuyama-shi (Japan) · 2024Review
- An international, multispecialty, expert-based Delphi Consensus document on controversial issues in the management of patients with asymptomatic and symptomatic carotid stenosis.Journal of vascular surgery · 2024Review
- Perioperative stroke.Nature reviews. Disease primers · 2024Review
- Dual Antiplatelet Therapy or Antiplatelet Plus Anticoagulant Therapy in Patients with Peripheral and Chronic Coronary Artery Disease: An Updated Review.Journal of clinical medicine · 2023Review
- A Propensity-Matched Comparison of Ischemic Brain Lesions on Postprocedural MRI in Endovascular versus Open Carotid Artery Reconstruction.Journal of cardiovascular development and disease · 2023Article
- Long-term outcomes of carotid artery stenting in patients with carotid artery stenosis: A single-center 14-year retrospective analysis.Journal of cerebrovascular and endovascular neurosurgery · 2023Article
- Prediction of new cerebral ischemic lesion after carotid artery stenting: a high-resolution vessel wall MRI-based radiomics analysis.European radiology · 2023Article
- Evolving Diagnostic and Management Advances in Coronary Heart Disease.Life (Basel, Switzerland) · 2023Review
- Evaluation of the association between silent ischemic lesions and stent design in carotid stenting applications.Revista da Associacao Medica Brasileira (1992) · 2023Article
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Authors and funding
15 authors.
Funding
Abstract
backgroundBrain lesions on diffusion-weighted imaging (DWI) are frequently found after carotid artery stenting (CAS), but their clinical relevance remains unclear.
objectivesThis study sought to investigate whether periprocedural ischemic DWI lesions after CAS or carotid endarterectomy (CEA) are associated with an increased risk of recurrent cerebrovascular events.
methodsIn the magnetic resonance imaging (MRI) substudy of ICSS (International Carotid Stenting Study), 231 patients with symptomatic carotid stenosis were randomized to undergo CAS (n=124) or CEA (n=107). MRIs were performed 1 to 7 days before and 1 to 3 days after treatment. The primary outcome event was stroke or transient ischemic attack in any territory occurring between the post-treatment MRI and the end of follow-up. Time to occurrence of the primary outcome event was compared between patients with (DWI+) and without (DWI-) new DWI lesions on the post-treatment scan in the CAS and CEA groups separately.
resultsMedian time of follow-up was 4.1 years (interquartile range: 3.0 to 5.2). In the CAS group, recurrent stroke or transient ischemic attack occurred more often among DWI+ patients (12 of 62) than among DWI- patients (6 of 62), with a cumulative 5-year incidence of 22.8% (standard error [SE]: 7.1%) and 8.8% (SE: 3.8%), respectively (unadjusted hazard ratio: 2.85; 95% confidence interval: 1.05 to 7.72; p=0.04). In DWI+ and DWI- patients, 8 and 2 events, respectively, occurred within 6 months after treatment. In the CEA group, there was no difference in recurrent cerebrovascular events between DWI+ and DWI- patients.
conclusionsIschemic brain lesions discovered on DWI after CAS seem to be a marker of increased risk for recurrent cerebrovascular events. Patients with periprocedural DWI lesions might benefit from more aggressive and prolonged antiplatelet therapy after CAS. (A Randomised Comparison of the Risks, Benefits and Cost Effectiveness of Primary Carotid Stenting With Carotid Endarterectomy: International Carotid Stenting Study; ISRCTN25337470).
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