3- and 7 Tesla MRI for detection of changes in white matter, cerebral perfusion and micro-/and macrovascular structures after revascularization of the carotid artery

10-15% of all strokes are caused by atherosclerotic stenosis of the internal
carotid artery. Carotid endarterectomy (CEA) and carotid artery stenting (CAS)
have been proven to reduce the long-term risk of stroke in patients with
symptomatic carotid artery stenosis. Unfortunately, this procedure is known to
be associated with serious periprocedural adverse events, occurring in up to 5%
of patients. The occurrence of postprocedural incidence of new diffusion
weighted imaging (DWI) lesion is relatively high in both CAS patients (50%)
and CEA patients (17%). These white matter lesions, with or without
corresponding focal deficits, may lead to clinically relevant future events
such as cognitive decline, dementia and increased risk of future
cerebrovascular events. In this study we aim to investigate changes on MR
imaging of the brain as a result of carotid artery endarterectomy or stenting.
We intend to identify small and large vessel characteristics as well as
cerebral perfusion for prediction of development of perioperative ischemic
lesions on both 3T and 7T MRI.

To investigate the development of white matter lesions, changes in cerebral
perfusion and cerebral vascular structures on 3T and 7T MRI following carotid
revascularization

Monocenter prospective observational study

The potential benefit for the enrolled patients is small except that these
patients will be monitored more closely than usual by MRI scans that will be
clinically evaluated for insidious pathology. Benefits in term of knowledge are
potentially very valuable as the study findings will substantially improve our
understanding of the risk of post-procedural complications. Risks are small
since there are no know risks associated with MRI acquisition.