Laboratory-based markers as predictors of brain infarction during carotid stenting: A prospective study

Aim: new ischemic lesions in the brain can be detected in approximately 50% of patients undergoing carotid artery stenting (cas). we wished to discover the laboratory-based predictors of new infarctions in the brain after cas. methods: all consecutive patients with internal carotid artery stenosis of ≥70% with indication for cas were enrolled in a prospective study for 16 months. all patients used dual antiplatelet therapy for ≥7 days before cas. neurologic examination and magnetic resonance imaging (mri) of the brain were undertaken before and at 24 h after cas. samples of venous blood were collected at <24 h before cas for the evaluation of hematology,reticulocytes,coagulation markers (pt,aptt,fbg,clauss),vwf antigen,pai-1 activity,pai-1 polymorphism 4g/5g,and the multiplate (aspirin and clopidogrel) resistance test. blood samples for the assessment of anti-xa activity were collected during cas. differences in the values of laboratory markers between patients with and without new ischemic lesions of the brain on control mri were evaluated. results: the cohort comprised 81 patients (53 males; mean age,67.3±7.2 years). new ischemic infarctions in the brain on control mri were found in 46 (56.8%) patients. three of seven patients with resistance to aspirin or clopidogrel had a new ischemic infarction in the brain. no significant differences for particular markers were found between patients with and without an ischemic lesion in the brain. conclusion: a high risk of a new ischemic infarction in the brain was detected in patients undergoing cas,but a laboratory-based predictor of such an infarction could not be identified. © 2016,japan atherosclerosis society. all rights reserved.