Stent placement versus percutaneous transluminal angioplasty of human carotid arteries in cadavers in situ: Distal embolization and findings at intravascular US, MR imaging, and histopathologic analysis'

PURPOSE: To compare endovascular stent placement with percutaneous translum inal angioplasty (PTA) of carotid arteries with respect to distal embolizat ion and findings at intravascular ultrasonography (US), magnetic resonance (MR) imaging, and histopathologic analysis. MATERIALS AND METHODS: PTA was performed in situ in one carotid artery, and stent placement was performed in the other, in ten cadavers (age range, 57 -82 years; mean age, 68 years) with severe atherosclerosis by using fluoros copic and intravascular US guidance. The carotid artery was connected to a pressurized tubing system in which a pulsatile pump circulated water. The e ffluent water was collected during the interventions,and after filtration a nd staining, the embolic material was analyzed histologically. After the in terventions, the arteries were excised and 1.5-T spin-echo MR imaging was p erformed. RESULTS: No difference in severity of distal embolization during stent plac ement versus during PTA was found. The embolic particles were composed main ly of intimal strips and cellular constituents of the atherosclerotic plaqu es. MR imaging accurately depicted postinterventional changes, and the find ings correlated closely with those of intravascular US and histopathologic analysis. CONCLUSION: Although stent placement and PTA were associated with equal dis tal embolization, the smooth surface and fully patent arterial lumen depict ed at intravascular US and MR imaging postinterventionally may indicate tha t stent placement is preferable to PTA.