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Journal of stroke
Sep, 2024;26 (3): 415-424.

Early Improvement in Interstitial Fluid Flow in Patients With Severe Carotid Stenosis After Angioplasty and Stenting.

Chia-Hung Wu, Shih-Pin Chen, Chih-Ping Chung, Kai-Wei Yu, Te-Ming Lin, Chao-Bao Luo, Jiing-Feng Lirng, I-Hui Lee, Feng-Chi Chang
Author Information
  1. Chia-Hung Wu: Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
  2. Shih-Pin Chen: School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
  3. Chih-Ping Chung: School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
  4. Kai-Wei Yu: Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
  5. Te-Ming Lin: Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
  6. Chao-Bao Luo: Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
  7. Jiing-Feng Lirng: Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
  8. I-Hui Lee: School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
  9. Feng-Chi Chang: Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
PMID: 39205535 DOI: 10.5853/jos.2023.04203

Abstract

BACKGROUND AND PURPOSE: This study aimed to investigate early changes in interstitial fluid (ISF) flow in patients with severe carotid stenosis after carotid angioplasty and stenting (CAS).
METHODS: We prospectively recruited participants with carotid stenosis ≥80% undergoing CAS at our institute between October 2019 and March 2023. Magnetic resonance imaging (MRI), including diffusion tensor imaging (DTI), and the Mini-Mental State Examination (MMSE) were performed 3 days before CAS. MRI with DTI and MMSE were conducted within 24 hours and 2 months after CAS, respectively. The diffusion tensor image analysis along the perivascular space (DTI-ALPS) index was calculated from the DTI data to determine the ISF status. Increments were defined as the ratio of the difference between post- and preprocedural values to preprocedural values.
RESULTS: In total, 102 participants (age: 67.1±8.9 years; stenosis: 89.5%±5.7%) with longitudinal data were evaluated. The DTI-ALPS index increased after CAS (0.85±0.15; 0.85 [0.22] vs. 0.86±0.14; 0.86 [0.21]; P=0.022), as did the MMSE score (25.9±3.7; 24.0 [4.0] vs. 26.9±3.4; 26.0 [3.0]; P<0.001). Positive correlations between increments in the DTI-ALPS index and MMSE score were found in all patients (rs=0.468; P<0.001).
CONCLUSION: An increased 24-hour post-CAS DTI-ALPS index suggests early improvement in ISF flow efficiency. The positive correlation between the 24-hour DTI-ALPS index and 2-month MMSE score increments suggests that early ISF flow improvement may contribute to long-term cognitive improvement after CAS.

Keywords

Cognition Diffusion tensor imaging Magnetic resonance imaging Prospective studies

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Grants

  1. V111B-032/Taipei Veterans General Hospital
  2. V112B-007/Taipei Veterans General Hospital
  3. V110C-037/Taipei Veterans General Hospital
  4. V111C-028/Taipei Veterans General Hospital
  5. V112C-059/Taipei Veterans General Hospital
  6. V112D67-002-MY3-1/Taipei Veterans General Hospital
  7. /Taipei Veterans General Hospital
  8. VGHUST 109V1-5-2/University System of Taiwan
  9. VGHUST 110-G1-5-2/University System of Taiwan
  10. 110-2314-B-075-005-/National Science and Technology Council, Taiwan
  11. 111-2314-B-075-025-MY3/National Science and Technology Council, Taiwan
  12. 109-2314-B-075-036/National Science and Technology Council, Taiwan
  13. 110-2314-B-075-032/National Science and Technology Council, Taiwan
  14. 112-2314-B-075-066-/National Science and Technology Council, Taiwan
  15. 113-2314-B-075-037-/National Science and Technology Council, Taiwan
  16. CI-109-3/Yen Tjing Ling Medical Foundation
  17. CI-111-2/Yen Tjing Ling Medical Foundation
  18. CI-112-2/Yen Tjing Ling Medical Foundation
  19. /Medical Scholarship Foundation In Memory Of Professor Albert Ly-Young Shen
  20. /Vivian W. Yen Neurological Foundation
Journal Article
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Word Cloud

Created with Highcharts 10.0.0CAS0MMSEDTI-ALPSindexISFimagingearlyflowcarotidtensorDTIscoreimprovementpatientsstenosisparticipantsMagneticresonanceMRIdiffusion24datapreproceduralvaluesincreased[0vs9±30]26P<0001increments24-hoursuggestsBACKGROUNDANDPURPOSE:studyaimedinvestigatechangesinterstitialfluidsevereangioplastystentingMETHODS:prospectivelyrecruited≥80%undergoinginstituteOctober2019March2023includingMini-MentalStateExaminationperformed3daysconductedwithinhours2monthsrespectivelyimageanalysisalongperivascularspacecalculateddeterminestatusIncrementsdefinedratiodifferencepost-RESULTS:total102age:671±89yearsstenosis:895%±57%longitudinalevaluated85±0158522]86±0148621]P=0022257[44[3Positivecorrelationsfoundrs=0468CONCLUSION:post-CASefficiencypositivecorrelation2-monthmaycontributelong-termcognitiveEarlyImprovementInterstitialFluidFlowPatientsSevereCarotidStenosisAngioplastyStentingCognitionDiffusionProspectivestudies

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