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 PS48. Impact of Patient’s Age on the Development of New Diffusion-weighted-positive Lesion on MRI After Carotid Endarterectomy and Carotid Artery Stenting

​Yang Jin Park1, Young-Wook Kim1, Shin Suk Yang1, Keun Myung Park1, Dong-Ik Kim1, Geon-Ha Kim2, Pyeong Jeon2, Kyong-Moon Kim3, Gwang-Woo Lee3
1Division of Vascular Surgery, Samsung Medical Center, Seoul, Republic of Korea; 2Department of Radiology, Samsung Medical Center, Seoul, Republic of Korea; 3Department of Neurology, Samsung Medical Center, Seoul, Republic of Korea.

OBJECTIVES: To determine an impact of patient’s age on the development of new DW (+) MRI lesion following carotid endarterectomy (CEA) or carotid artery stenting (CAS).

METHODS: Among patients who underwent CEA or CAS during the period of the last 15 years, comparison of pre- and post, (<30 days) treatment brain MRI was available in 574 patients. CAS not using embolic protective device (n=55), coexisting atrial fibrillation (n=22), CEA concomitant with coronary or aortic surgery (n=16), procedural failure of CAS (n=1), and prior history of cardiac valve replacement surgery (n=1) were excluded. To determine age influence on the development of DW (+) lesion, we compared frequencies of new DW (+) lesions between younger and older (≥65 y) age group in CEA and CAS groups after adjusting sex and symptom status.

RESULTS: 244 CEA patients (mean age 67years, range 47-83; male, 91%; symptomatic, 39%) and 234 CAS patients (mean age, 68years, range 43-92; male, 86%; symptomatic 58%) were included for this comparative analysis. The frequencies of new DW-positive lesions according to the age after CEA vs. CAS were summarized in table.

CONCLUSIONS: On a sex and symptom status adjusted multiple logistic regression analysis, new DW(+) MRI lesion was significantly more frequent in patients ≥65 years of age in CAS group (p<0.025, OR 1.91 (1.11-3.4) but not in CEA group (p=0.897) in Korean patients.

AUTHOR DISCLOSURES: P. Jeon, Nothing to disclose; D. Kim, Nothing to disclose; G. Kim, Nothing to disclose; K. Kim, Nothing to disclose; Y. Kim, Nothing to disclose; G. Lee, Nothing to disclose; K. Park, Nothing to disclose; Y. Park, Nothing to disclose; S. Yang, Nothing to disclose.
Frequencies of new DW-positive MRI lesions after CEA vs. CAS according to the age and symptomatic status

Frequencies of new DW-positive MRI lesions after CEA vs. CAS according to the age and symptomatic status

Frequencies of New DW (+) Lesion According to the Age (Year)
<54
55-64
65-74
>74
CEA, Symptomatic (n=96)
none
3%
2%
2%
CAS, Symptomatic (n=136)
2%
5%
14%
11%
CEA, Asymptomatic (n=148)
1%
1%
3%
1%
CAS, Asymptomatic (n=98)
1%
5%
12%
4%

DW(+) lesion, diffusion-weighted positive lesion; CEA, carotid endarterectomy; CAS, carotid artery stenting; Symptomatic, presence of neurologic or ocular symptom within recent 6 months.


Posted April 2012

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