Brachial-Ankle Pulse Wave Velocity as a Predictor of Silent Cerebral Embolism after Carotid Artery Stenting

J Stroke Cerebrovasc Dis. 2017 Oct;26(10):2329-2335. doi: 10.1016/j.jstrokecerebrovasdis.2017.05.021. Epub 2017 Jun 8.

Abstract

Background: In neuroendovascular therapy, the effect of arterial stiffness on postprocedural cerebral thromboembolism is unknown. In this observational study, we examined the relationship between cerebral thromboembolism after carotid artery stenting and arterial stiffness.

Methods: From April 2015 to February 2017, we enrolled consecutive patients undergoing scheduled carotid artery stenting in our institution. In all patients, preprocedural brachial-ankle pulse wave velocity was used to assess arterial stiffness, whereas the number of new cerebral ischemic lesions on diffusion-weighted magnetic resonance imaging was assessed after treatment. We also analyzed patient data and details of procedures in patients with carotid artery stenting.

Results: Twenty-one patients completed the study. The mean brachial-ankle pulse wave velocity was 1879 cm/s. There was no association of cerebral thromboembolisms with age, unstable plaque, protection device, or type of stent. However, the brachial-ankle pulse wave velocity was an independent predictor of cerebral thromboembolisms (P = .0017).

Conclusions: Brachial-ankle pulse wave velocity is predictive of silent cerebral embolisms on diffusion-weighted magnetic resonance imaging after carotid artery stenting.

Keywords: Neuroendovascular therapy; arterial stiffness; asymptomatic ischemic lesions; baPWV; carotid artery stenosis; carotid artery stenting; predictor; silent cerebral embolism.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Ankle Brachial Index*
  • Brain Ischemia / diagnosis
  • Brain Ischemia / physiopathology
  • Carotid Arteries / diagnostic imaging
  • Carotid Arteries / surgery*
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Humans
  • Intracranial Embolism / diagnosis*
  • Intracranial Embolism / physiopathology
  • Magnetic Resonance Angiography
  • Male
  • Multivariate Analysis
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / physiopathology
  • Prospective Studies
  • Pulse Wave Analysis*
  • Stents*
  • Vascular Stiffness