Abstract

Link between Systemic and Cerebral Circulatory Levels of Microparticles and Necrosis Area of Stenotic Carotid Artery in the Patients Undergoing Carotid Stenting

Author(s): Pei-Hsun Sung, Meng-Shen Tong, Chi-Hsiang Chu, Fan-Yan Lee, Hon-Kan Yip

ABSTRACT

Objective: We tested the hypothesis that (1) platelet-derived activated microparticles (PDAc- MPs) and endothelial-derived activated (EDAc)-MPs were significantly higher after carotid stenting (CS) than before CS in carotid artery (CA) (defined as systemic circulation) and internal jugular vein (IJV) (defined as cerebral circulation) and (2) significantly correlated with necrotic area in CA stenosis measured by virtual histology intra-vascular ultrasound (VH-IVUS) prior to CS.

Methods: From September 2013 to 2016 July, a total of 92 consecutive patients undergoing CS were prospectively enrolled into the study. Blood samples for level of MPs were collected from CA and IJV prior to and 5-mintes after CS, respectively.

Results: The frequency of previous ischemic stroke (IS) was 45.7% (42/92). The mean stenosis prior to CS was 88.8%. The procedural success was 100% and incidences of TIA and acute IS were 3.3% (3/92) and 4.3% (4/92), respectively. No significant correlation existed between severity of CA stenosis and circulating MPs level (p>0.5). The PDAc-MPs was significantly higher in post-CS procedure than in pre-CS procedure in both RIJV and CA (all p<0.007), whereas the EDAc-MPs was significantly higher in post-CS procedure than in pre-CS procedure in CA (p=0.003). Post-CS PDAc-MPs and EDAc-MPs as well as ratio of post- to pre-CS PDAc-MPs were moderately correlated to necrotic area of carotid plagues (all p<0.005).

Conclusion: Cerebral and systemic PDAc-MPs and systemic EDAc-MPs were markedly increased in post CS than in that of prior to CS. Post-CS PDAc-MPs/EDAc-MPs and ratio of post/pre-CS PDAc-MPs were notably correlated to necrotic area of stenotic carotid plaque.