Silent new cerebral ischemic lesions (sNCIL) are a common complication of carotid artery stenting (CAS) that can lead to an increase in morbidity and mortality. We aimed to evaluate the impact of hematological parameters on sNCIL in patients undergoing CAS. We retrospectively evaluated 103 patients who underwent CAS, with a mean age of 70.5 ± 6.7 years, and 31 (20.1 %) of whom were female. Stents were placed for internal carotid artery revascularization. The presence of new hyperintense lesions on diffusion-weighted imaging (DWI) without neurological symptoms was considered as sNCIL in cases without apparent neurological findings. Patients were categorized into two groups based on DWI results: positive (29) and negative (74). In the study population, sNCIL was observed in 29 patients (28.2 %). The DWI-positive group exhibited significantly higher Plateletcrit (PCT) levels, advanced age, and a lack of embolic protection device usage compared to the DWI-negative group. The Receiver Operating Characteristic (ROC) analysis identified a PCT value of 0.26 as the optimal threshold, detecting the development of sNCIL with a sensitivity of 75.9 % and specificity of 59.1 % (AUC: 0.700; 95 % CI: 0.594–0.806, p = 0.002). To be determined by a simple blood parameter, PCT can predict the risk of sNCIL before CAS and holds clinical value in the treatment of patients with carotid artery stenosis.

中文翻译：

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颈动脉支架置入术中新发无症状脑缺血病变的血液学预测因素：一项回顾性研究

无症状新脑缺血性病变 (sNCIL) 是颈动脉支架置入术 (CAS) 的常见并发症，可导致发病率和死亡率增加。我们的目的是评估血液学参数对 CAS 患者 sNCIL 的影响。我们回顾性评估了 103 名接受 CAS 的患者，平均年龄为 70.5 ± 6.7 岁，其中 31 名 (20.1%) 为女性。放置支架用于颈内动脉血运重建。在没有明显神经系统发现的病例中，弥散加权成像 (DWI) 上出现新的高信号病变但没有神经系统症状的情况被视为 sNCIL。根据 DWI 结果将患者分为两组：阳性组 (29 例) 和阴性组 (74 例)。在研究人群中，29 名患者 (28.2%) 观察到 sNCIL。与 DWI 阴性组相比，DWI 阳性组表现出明显更高的血小板压积 (PCT) 水平、高龄以及缺乏栓塞保护装置的使用。受试者操作特征 (ROC) 分析确定 PCT 值为 0.26 为最佳阈值，检测 sNCIL 的发展，灵敏度为 75.9%，特异性为 59.1%（AUC：0.700；95% CI：0.594-0.806，p = 0.002）。通过简单的血液参数确定，PCT可以在CAS之前预测sNCIL的风险，对颈动脉狭窄患者的治疗具有临床价值。