{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:15:41Z","timestamp":1777526141614,"version":"3.51.4"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Purpose\u2014<\/jats:title>\n                    <jats:p>In a substudy of the International Carotid Stenting Study (ICSS), more patients had new ischemic brain lesions on diffusion-weighted magnetic resonance imaging (MRI) after stenting (CAS) than after endarterectomy (CEA). In the present analysis, we compared characteristics of diffusion-weighted MRI lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods\u2014<\/jats:title>\n                    <jats:p>Number, individual and total volumes, and location of new diffusion-weighted MRI lesions were compared in patients with symptomatic carotid stenosis randomized to CAS (n=124) or CEA (n=107) in the ICSS-MRI substudy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results\u2014<\/jats:title>\n                    <jats:p>\n                      CAS patients had higher lesion numbers than CEA patients (1 lesion, 15% vs 8%; 2\u20135 lesions, 19% vs 5%; &gt;5 lesions, 16% vs 4%). The overall risk ratio for the expected lesion count with CAS versus CEA was 8.8 (95% confidence interval, 4.4\u201317.5;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001) and significantly increased among patients with lower blood pressure at randomization, diabetes mellitus, stroke as the qualifying event, left-side stenosis, and if patients were treated at centers routinely using filter-type protection devices during CAS. Individual lesions were smaller in the CAS group than in the CEA group (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001). Total lesion volume per patient did not differ significantly. Lesions in the CAS group were more likely to occur in cortical areas and subjacent white matter supplied by leptomeningeal arteries than lesions in the CEA group (odds ratio, 4.2; 95% confidence interval, 1.7\u201310.2;\n                      <jats:italic>P<\/jats:italic>\n                      =0.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>Compared with patients undergoing CEA, patients treated with CAS had higher numbers of periprocedural ischemic brain lesions, and lesions were smaller and more likely to occur in cortical areas and subjacent white matter. These findings may reflect differences in underlying mechanisms of cerebral ischemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.isrctn.org\">http:\/\/www.isrctn.org<\/jats:ext-link>\n                      . Unique identifier: ISRCTN25337470.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.112.673152","type":"journal-article","created":{"date-parts":[[2012,12,14]],"date-time":"2012-12-14T02:22:39Z","timestamp":1355451759000},"page":"80-86","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":59,"title":["Characteristics of Ischemic Brain Lesions After Stenting or Endarterectomy for Symptomatic Carotid Artery Stenosis"],"prefix":"10.1161","volume":"44","author":[{"given":"Henrik","family":"Gensicke","sequence":"first","affiliation":[{"name":"From the Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (H.G., P.A.L., S.T.E., L.H.B.); Clinical Trial Unit, University Hospital Basel, Basel, Switzerland (T.Z.); Department of Radiology (L.M.J., W.P.T.M.M.) and Department of Neurology, Rudolf Magnus Institute of Neuroscience (H.B.v.d.W.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Neurology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands (P.J.N.); Department of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Zumbrunn","sequence":"additional","affiliation":[{"name":"From the Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (H.G., P.A.L., S.T.E., L.H.B.); Clinical Trial Unit, University Hospital Basel, Basel, Switzerland (T.Z.); Department of Radiology (L.M.J., W.P.T.M.M.) and Department of Neurology, Rudolf Magnus Institute of Neuroscience (H.B.v.d.W.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Neurology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands (P.J.N.); Department of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa M.","family":"Jongen","sequence":"additional","affiliation":[{"name":"From the Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (H.G., P.A.L., S.T.E., L.H.B.); Clinical Trial Unit, University Hospital Basel, Basel, Switzerland (T.Z.); Department of Radiology (L.M.J., W.P.T.M.M.) and Department of Neurology, Rudolf Magnus Institute of Neuroscience (H.B.v.d.W.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Neurology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands (P.J.N.); Department of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul J.","family":"Nederkoorn","sequence":"additional","affiliation":[{"name":"From the Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (H.G., P.A.L., S.T.E., L.H.B.); Clinical Trial Unit, University Hospital Basel, Basel, Switzerland (T.Z.); Department of Radiology (L.M.J., W.P.T.M.M.) and Department of Neurology, Rudolf Magnus Institute of Neuroscience (H.B.v.d.W.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Neurology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands (P.J.N.); Department of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumaira","family":"Macdonald","sequence":"additional","affiliation":[{"name":"From the Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (H.G., P.A.L., S.T.E., L.H.B.); Clinical Trial Unit, University Hospital Basel, Basel, Switzerland (T.Z.); Department of Radiology (L.M.J., W.P.T.M.M.) and Department of Neurology, Rudolf Magnus Institute of Neuroscience (H.B.v.d.W.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Neurology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands (P.J.N.); Department of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter A.","family":"Gaines","sequence":"additional","affiliation":[{"name":"From the Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (H.G., P.A.L., S.T.E., L.H.B.); Clinical Trial Unit, University Hospital Basel, Basel, Switzerland (T.Z.); Department of Radiology (L.M.J., W.P.T.M.M.) and Department of Neurology, Rudolf Magnus Institute of Neuroscience (H.B.v.d.W.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Neurology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands (P.J.N.); Department of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe A.","family":"Lyrer","sequence":"additional","affiliation":[{"name":"From the Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (H.G., P.A.L., S.T.E., L.H.B.); Clinical Trial Unit, University Hospital Basel, Basel, Switzerland (T.Z.); Department of Radiology (L.M.J., W.P.T.M.M.) and Department of Neurology, Rudolf Magnus Institute of Neuroscience (H.B.v.d.W.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Neurology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands (P.J.N.); Department of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan G.","family":"Wetzel","sequence":"additional","affiliation":[{"name":"From the Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (H.G., P.A.L., S.T.E., L.H.B.); Clinical Trial Unit, University Hospital Basel, Basel, Switzerland (T.Z.); Department of Radiology (L.M.J., W.P.T.M.M.) and Department of Neurology, Rudolf Magnus Institute of Neuroscience (H.B.v.d.W.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Neurology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands (P.J.N.); Department of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aad","family":"van der Lugt","sequence":"additional","affiliation":[{"name":"From the Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (H.G., P.A.L., S.T.E., L.H.B.); Clinical Trial Unit, University Hospital Basel, Basel, Switzerland (T.Z.); Department of Radiology (L.M.J., W.P.T.M.M.) and Department of Neurology, Rudolf Magnus Institute of Neuroscience (H.B.v.d.W.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Neurology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands (P.J.N.); 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M.","family":"Mali","sequence":"additional","affiliation":[{"name":"From the Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (H.G., P.A.L., S.T.E., L.H.B.); Clinical Trial Unit, University Hospital Basel, Basel, Switzerland (T.Z.); Department of Radiology (L.M.J., W.P.T.M.M.) and Department of Neurology, Rudolf Magnus Institute of Neuroscience (H.B.v.d.W.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Neurology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands (P.J.N.); Department of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin M.","family":"Brown","sequence":"additional","affiliation":[{"name":"From the Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (H.G., P.A.L., S.T.E., L.H.B.); Clinical Trial Unit, University Hospital Basel, Basel, Switzerland (T.Z.); Department of Radiology (L.M.J., W.P.T.M.M.) and Department of Neurology, Rudolf Magnus Institute of Neuroscience (H.B.v.d.W.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Neurology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands (P.J.N.); Department of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. Bart","family":"van der Worp","sequence":"additional","affiliation":[{"name":"From the Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (H.G., P.A.L., S.T.E., L.H.B.); Clinical Trial Unit, University Hospital Basel, Basel, Switzerland (T.Z.); Department of Radiology (L.M.J., W.P.T.M.M.) and Department of Neurology, Rudolf Magnus Institute of Neuroscience (H.B.v.d.W.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Neurology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands (P.J.N.); Department of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan T.","family":"Engelter","sequence":"additional","affiliation":[{"name":"From the Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (H.G., P.A.L., S.T.E., L.H.B.); Clinical Trial Unit, University Hospital Basel, Basel, Switzerland (T.Z.); Department of Radiology (L.M.J., W.P.T.M.M.) and Department of Neurology, Rudolf Magnus Institute of Neuroscience (H.B.v.d.W.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Neurology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands (P.J.N.); Department of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leo H.","family":"Bonati","sequence":"additional","affiliation":[{"name":"From the Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (H.G., P.A.L., S.T.E., L.H.B.); Clinical Trial Unit, University Hospital Basel, Basel, Switzerland (T.Z.); Department of Radiology (L.M.J., W.P.T.M.M.) and Department of Neurology, Rudolf Magnus Institute of Neuroscience (H.B.v.d.W.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Neurology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands (P.J.N.); Department of..."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60239-5"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70057-0"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.22.6.711"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.30.3.502"},{"key":"e_1_3_3_6_2","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1017\/CBO9780511586521.030","volume-title":"Stroke Syndromes","author":"Tatu L","year":"2001","unstructured":"Tatu L, Moulin T, Bogousslavsky J, Duvernoy H. 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