The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform

Toru Iwama - One of the best experts on this subject based on the ideXlab platform.

  • Prediction of Silent Ischemic Lesions after Carotid Artery Stenting Using Virtual Histology Intravascular Ultrasound
    Cerebrovascular diseases (Basel Switzerland), 2011
    Co-Authors: Kiyofumi Yamada, Shinichi Yoshimura, Masanori Kawasaki, Yukiko Enomoto, Kyohei Takano, Takahiko Asano, Shinya Minatoguchi, Toru Iwama
    Abstract:

    Background: A major concern with carotid artery stenting (CAS) is the potential for cerebral embolism. The purpose of this study was to determine whether virtual histology intravascular ultrasound (VH-IVUS) can predict the risk of a silent ischemic lesion after CAS. Methods: We performed CAS in 45 patients with carotid stenosis. Before CAS, we assessed plaque characteristics by VH-IVUS. We also performed diffusion-weighted magnetic resonance imaging of the brain before and after CAS to detect newly appearing ipsilateral silent ischemic lesions (Nisil). Results: In the patient group that was positive for Nisil (P group: n = 18), the relative fibrofatty (FF) area identified by VH-IVUS in 5 cross-sections including the most stenotic lesion was significantly larger than that in areas of the Nisil-negative group (N group: n = 27; 32.7 ± 13.2 and 18.3 ± 9.8%, respectively; p Conclusions: Quantitative tissue characterization of atherosclerotic lesions of carotid arteries using VH-IVUS was useful to predict Nisil after CAS. However, the positive predictive value determined by VH-IVUS was not superior to that determined by a noninvasive method.

  • Embolic complications after carotid artery stenting or carotid endarterectomy are associated with tissue characteristics of carotid plaques evaluated by magnetic resonance imaging.
    Atherosclerosis, 2011
    Co-Authors: Kiyofumi Yamada, Shinichi Yoshimura, Masanori Kawasaki, Yukiko Enomoto, Takahiko Asano, Shinya Minatoguchi, Akira Hara, Toru Iwama
    Abstract:

    Background: Unstable carotid plaques are associated with an increased incidence of embolic complications after carotid artery stenting (CAS) or carotid endarterectomy (CEA). The aim of this study was to elucidate the relationship between the tissue components of carotid plaques and the incidence of new ipsilateral silent ischemic lesions (Nisil) after CAS or CEA. Methods: We performed CAS in 56 patients and CEA in 25 patients. We also performed quantitative analyses of carotid plaque characteristics before treatment using T1 weighted black-blood magnetic resonance imaging (BB-MRI). The signal intensity ratio (SIR) was defined as the ratio of signal intensity evaluated by BB-MRI in carotid plaques to that of sternocleidomastoid muscle. According to criteria that we and other investigators previously reported, an SIR ≥ 1.25 was defined as “high”. Nisil were evaluated by diffusion-weighted imaging of MRI before and after CAS or CEA. Results: In the high SIR group, the incidence of Nisil was significantly greater after CAS than after CEA (61% vs 13%, respectively, p = 0.006), whereas there were no significant difference in Nisil after the two procedures when the SIR was

  • Prediction of silent ischemic lesions after carotid artery stenting using integrated backscatter ultrasound and magnetic resonance imaging
    Atherosclerosis, 2009
    Co-Authors: Kiyofumi Yamada, Shinichi Yoshimura, Masanori Kawasaki, Yukiko Enomoto, Takahiko Asano, Shinya Minatoguchi, Toru Iwama
    Abstract:

    Objective: A major concern with carotid artery stenting (CAS) is the potential for cerebral embolism. The purpose of this study was to determine whether integrated backscatter (IBS) ultrasound and black-blood magnetic resonance imaging (BB-MRI) can predict the risk of a silent ischemic lesion after CAS. Methods: We performed quantitative analysis of plaque characteristics in carotid arteries using IBS ultrasound and BB-MRI before CAS in 50 patients. We measured IBS values and the signal intensity ratio (SIR) from T1 weighted images of all plaques. We also performed diffusion-weighted (DWI) MRI of the brain before and after CAS. Results: In the patient group that was positive (n = 19) for newly appearing ipsilateral silent ischemic lesions (Nisil), relative unstable component area (%UCA) evaluated by IBS analysis (60.2 ± 23.4% and 35.3 ± 19.2%, p < 0.001) and SIR (1.40 ± 0.19 and 1.18 ± 0.25, p < 0.01) in most stenotic lesions were higher than in the Nisil-negative group (n = 31). From the analysis of receiver operating characteristic curves, 50% of the %UCA measured by IBS and an SIR of 1.25 measured by BB-MRI were the most reliable cutoff values for predicting Nisil. In multivariate logistic regression analysis, the independent predictors of Nisil were SIR (p = 0.030), the CRP level (p = 0.041) and the %UCA measured by IBS (p = 0.049). Conclusions: Quantitative tissue characterization of carotid plaques using IBS ultrasound and BB-MRI was useful to predict Nisil after CAS. The plaque components in carotid arteries should be evaluated by BB-MRI or IBS ultrasound before CAS to improve the clinical outcome of this procedure.

Kiyofumi Yamada - One of the best experts on this subject based on the ideXlab platform.

  • Prediction of Silent Ischemic Lesions after Carotid Artery Stenting Using Virtual Histology Intravascular Ultrasound
    Cerebrovascular diseases (Basel Switzerland), 2011
    Co-Authors: Kiyofumi Yamada, Shinichi Yoshimura, Masanori Kawasaki, Yukiko Enomoto, Kyohei Takano, Takahiko Asano, Shinya Minatoguchi, Toru Iwama
    Abstract:

    Background: A major concern with carotid artery stenting (CAS) is the potential for cerebral embolism. The purpose of this study was to determine whether virtual histology intravascular ultrasound (VH-IVUS) can predict the risk of a silent ischemic lesion after CAS. Methods: We performed CAS in 45 patients with carotid stenosis. Before CAS, we assessed plaque characteristics by VH-IVUS. We also performed diffusion-weighted magnetic resonance imaging of the brain before and after CAS to detect newly appearing ipsilateral silent ischemic lesions (Nisil). Results: In the patient group that was positive for Nisil (P group: n = 18), the relative fibrofatty (FF) area identified by VH-IVUS in 5 cross-sections including the most stenotic lesion was significantly larger than that in areas of the Nisil-negative group (N group: n = 27; 32.7 ± 13.2 and 18.3 ± 9.8%, respectively; p Conclusions: Quantitative tissue characterization of atherosclerotic lesions of carotid arteries using VH-IVUS was useful to predict Nisil after CAS. However, the positive predictive value determined by VH-IVUS was not superior to that determined by a noninvasive method.

  • Embolic complications after carotid artery stenting or carotid endarterectomy are associated with tissue characteristics of carotid plaques evaluated by magnetic resonance imaging.
    Atherosclerosis, 2011
    Co-Authors: Kiyofumi Yamada, Shinichi Yoshimura, Masanori Kawasaki, Yukiko Enomoto, Takahiko Asano, Shinya Minatoguchi, Akira Hara, Toru Iwama
    Abstract:

    Background: Unstable carotid plaques are associated with an increased incidence of embolic complications after carotid artery stenting (CAS) or carotid endarterectomy (CEA). The aim of this study was to elucidate the relationship between the tissue components of carotid plaques and the incidence of new ipsilateral silent ischemic lesions (Nisil) after CAS or CEA. Methods: We performed CAS in 56 patients and CEA in 25 patients. We also performed quantitative analyses of carotid plaque characteristics before treatment using T1 weighted black-blood magnetic resonance imaging (BB-MRI). The signal intensity ratio (SIR) was defined as the ratio of signal intensity evaluated by BB-MRI in carotid plaques to that of sternocleidomastoid muscle. According to criteria that we and other investigators previously reported, an SIR ≥ 1.25 was defined as “high”. Nisil were evaluated by diffusion-weighted imaging of MRI before and after CAS or CEA. Results: In the high SIR group, the incidence of Nisil was significantly greater after CAS than after CEA (61% vs 13%, respectively, p = 0.006), whereas there were no significant difference in Nisil after the two procedures when the SIR was

  • Prediction of silent ischemic lesions after carotid artery stenting using integrated backscatter ultrasound and magnetic resonance imaging
    Atherosclerosis, 2009
    Co-Authors: Kiyofumi Yamada, Shinichi Yoshimura, Masanori Kawasaki, Yukiko Enomoto, Takahiko Asano, Shinya Minatoguchi, Toru Iwama
    Abstract:

    Objective: A major concern with carotid artery stenting (CAS) is the potential for cerebral embolism. The purpose of this study was to determine whether integrated backscatter (IBS) ultrasound and black-blood magnetic resonance imaging (BB-MRI) can predict the risk of a silent ischemic lesion after CAS. Methods: We performed quantitative analysis of plaque characteristics in carotid arteries using IBS ultrasound and BB-MRI before CAS in 50 patients. We measured IBS values and the signal intensity ratio (SIR) from T1 weighted images of all plaques. We also performed diffusion-weighted (DWI) MRI of the brain before and after CAS. Results: In the patient group that was positive (n = 19) for newly appearing ipsilateral silent ischemic lesions (Nisil), relative unstable component area (%UCA) evaluated by IBS analysis (60.2 ± 23.4% and 35.3 ± 19.2%, p < 0.001) and SIR (1.40 ± 0.19 and 1.18 ± 0.25, p < 0.01) in most stenotic lesions were higher than in the Nisil-negative group (n = 31). From the analysis of receiver operating characteristic curves, 50% of the %UCA measured by IBS and an SIR of 1.25 measured by BB-MRI were the most reliable cutoff values for predicting Nisil. In multivariate logistic regression analysis, the independent predictors of Nisil were SIR (p = 0.030), the CRP level (p = 0.041) and the %UCA measured by IBS (p = 0.049). Conclusions: Quantitative tissue characterization of carotid plaques using IBS ultrasound and BB-MRI was useful to predict Nisil after CAS. The plaque components in carotid arteries should be evaluated by BB-MRI or IBS ultrasound before CAS to improve the clinical outcome of this procedure.

Masanori Kawasaki - One of the best experts on this subject based on the ideXlab platform.

  • Prediction of Silent Ischemic Lesions after Carotid Artery Stenting Using Virtual Histology Intravascular Ultrasound
    Cerebrovascular diseases (Basel Switzerland), 2011
    Co-Authors: Kiyofumi Yamada, Shinichi Yoshimura, Masanori Kawasaki, Yukiko Enomoto, Kyohei Takano, Takahiko Asano, Shinya Minatoguchi, Toru Iwama
    Abstract:

    Background: A major concern with carotid artery stenting (CAS) is the potential for cerebral embolism. The purpose of this study was to determine whether virtual histology intravascular ultrasound (VH-IVUS) can predict the risk of a silent ischemic lesion after CAS. Methods: We performed CAS in 45 patients with carotid stenosis. Before CAS, we assessed plaque characteristics by VH-IVUS. We also performed diffusion-weighted magnetic resonance imaging of the brain before and after CAS to detect newly appearing ipsilateral silent ischemic lesions (Nisil). Results: In the patient group that was positive for Nisil (P group: n = 18), the relative fibrofatty (FF) area identified by VH-IVUS in 5 cross-sections including the most stenotic lesion was significantly larger than that in areas of the Nisil-negative group (N group: n = 27; 32.7 ± 13.2 and 18.3 ± 9.8%, respectively; p Conclusions: Quantitative tissue characterization of atherosclerotic lesions of carotid arteries using VH-IVUS was useful to predict Nisil after CAS. However, the positive predictive value determined by VH-IVUS was not superior to that determined by a noninvasive method.

  • Embolic complications after carotid artery stenting or carotid endarterectomy are associated with tissue characteristics of carotid plaques evaluated by magnetic resonance imaging.
    Atherosclerosis, 2011
    Co-Authors: Kiyofumi Yamada, Shinichi Yoshimura, Masanori Kawasaki, Yukiko Enomoto, Takahiko Asano, Shinya Minatoguchi, Akira Hara, Toru Iwama
    Abstract:

    Background: Unstable carotid plaques are associated with an increased incidence of embolic complications after carotid artery stenting (CAS) or carotid endarterectomy (CEA). The aim of this study was to elucidate the relationship between the tissue components of carotid plaques and the incidence of new ipsilateral silent ischemic lesions (Nisil) after CAS or CEA. Methods: We performed CAS in 56 patients and CEA in 25 patients. We also performed quantitative analyses of carotid plaque characteristics before treatment using T1 weighted black-blood magnetic resonance imaging (BB-MRI). The signal intensity ratio (SIR) was defined as the ratio of signal intensity evaluated by BB-MRI in carotid plaques to that of sternocleidomastoid muscle. According to criteria that we and other investigators previously reported, an SIR ≥ 1.25 was defined as “high”. Nisil were evaluated by diffusion-weighted imaging of MRI before and after CAS or CEA. Results: In the high SIR group, the incidence of Nisil was significantly greater after CAS than after CEA (61% vs 13%, respectively, p = 0.006), whereas there were no significant difference in Nisil after the two procedures when the SIR was

  • Prediction of silent ischemic lesions after carotid artery stenting using integrated backscatter ultrasound and magnetic resonance imaging
    Atherosclerosis, 2009
    Co-Authors: Kiyofumi Yamada, Shinichi Yoshimura, Masanori Kawasaki, Yukiko Enomoto, Takahiko Asano, Shinya Minatoguchi, Toru Iwama
    Abstract:

    Objective: A major concern with carotid artery stenting (CAS) is the potential for cerebral embolism. The purpose of this study was to determine whether integrated backscatter (IBS) ultrasound and black-blood magnetic resonance imaging (BB-MRI) can predict the risk of a silent ischemic lesion after CAS. Methods: We performed quantitative analysis of plaque characteristics in carotid arteries using IBS ultrasound and BB-MRI before CAS in 50 patients. We measured IBS values and the signal intensity ratio (SIR) from T1 weighted images of all plaques. We also performed diffusion-weighted (DWI) MRI of the brain before and after CAS. Results: In the patient group that was positive (n = 19) for newly appearing ipsilateral silent ischemic lesions (Nisil), relative unstable component area (%UCA) evaluated by IBS analysis (60.2 ± 23.4% and 35.3 ± 19.2%, p < 0.001) and SIR (1.40 ± 0.19 and 1.18 ± 0.25, p < 0.01) in most stenotic lesions were higher than in the Nisil-negative group (n = 31). From the analysis of receiver operating characteristic curves, 50% of the %UCA measured by IBS and an SIR of 1.25 measured by BB-MRI were the most reliable cutoff values for predicting Nisil. In multivariate logistic regression analysis, the independent predictors of Nisil were SIR (p = 0.030), the CRP level (p = 0.041) and the %UCA measured by IBS (p = 0.049). Conclusions: Quantitative tissue characterization of carotid plaques using IBS ultrasound and BB-MRI was useful to predict Nisil after CAS. The plaque components in carotid arteries should be evaluated by BB-MRI or IBS ultrasound before CAS to improve the clinical outcome of this procedure.

Shinichi Yoshimura - One of the best experts on this subject based on the ideXlab platform.

  • Prediction of Silent Ischemic Lesions after Carotid Artery Stenting Using Virtual Histology Intravascular Ultrasound
    Cerebrovascular diseases (Basel Switzerland), 2011
    Co-Authors: Kiyofumi Yamada, Shinichi Yoshimura, Masanori Kawasaki, Yukiko Enomoto, Kyohei Takano, Takahiko Asano, Shinya Minatoguchi, Toru Iwama
    Abstract:

    Background: A major concern with carotid artery stenting (CAS) is the potential for cerebral embolism. The purpose of this study was to determine whether virtual histology intravascular ultrasound (VH-IVUS) can predict the risk of a silent ischemic lesion after CAS. Methods: We performed CAS in 45 patients with carotid stenosis. Before CAS, we assessed plaque characteristics by VH-IVUS. We also performed diffusion-weighted magnetic resonance imaging of the brain before and after CAS to detect newly appearing ipsilateral silent ischemic lesions (Nisil). Results: In the patient group that was positive for Nisil (P group: n = 18), the relative fibrofatty (FF) area identified by VH-IVUS in 5 cross-sections including the most stenotic lesion was significantly larger than that in areas of the Nisil-negative group (N group: n = 27; 32.7 ± 13.2 and 18.3 ± 9.8%, respectively; p Conclusions: Quantitative tissue characterization of atherosclerotic lesions of carotid arteries using VH-IVUS was useful to predict Nisil after CAS. However, the positive predictive value determined by VH-IVUS was not superior to that determined by a noninvasive method.

  • Embolic complications after carotid artery stenting or carotid endarterectomy are associated with tissue characteristics of carotid plaques evaluated by magnetic resonance imaging.
    Atherosclerosis, 2011
    Co-Authors: Kiyofumi Yamada, Shinichi Yoshimura, Masanori Kawasaki, Yukiko Enomoto, Takahiko Asano, Shinya Minatoguchi, Akira Hara, Toru Iwama
    Abstract:

    Background: Unstable carotid plaques are associated with an increased incidence of embolic complications after carotid artery stenting (CAS) or carotid endarterectomy (CEA). The aim of this study was to elucidate the relationship between the tissue components of carotid plaques and the incidence of new ipsilateral silent ischemic lesions (Nisil) after CAS or CEA. Methods: We performed CAS in 56 patients and CEA in 25 patients. We also performed quantitative analyses of carotid plaque characteristics before treatment using T1 weighted black-blood magnetic resonance imaging (BB-MRI). The signal intensity ratio (SIR) was defined as the ratio of signal intensity evaluated by BB-MRI in carotid plaques to that of sternocleidomastoid muscle. According to criteria that we and other investigators previously reported, an SIR ≥ 1.25 was defined as “high”. Nisil were evaluated by diffusion-weighted imaging of MRI before and after CAS or CEA. Results: In the high SIR group, the incidence of Nisil was significantly greater after CAS than after CEA (61% vs 13%, respectively, p = 0.006), whereas there were no significant difference in Nisil after the two procedures when the SIR was

  • Prediction of silent ischemic lesions after carotid artery stenting using integrated backscatter ultrasound and magnetic resonance imaging
    Atherosclerosis, 2009
    Co-Authors: Kiyofumi Yamada, Shinichi Yoshimura, Masanori Kawasaki, Yukiko Enomoto, Takahiko Asano, Shinya Minatoguchi, Toru Iwama
    Abstract:

    Objective: A major concern with carotid artery stenting (CAS) is the potential for cerebral embolism. The purpose of this study was to determine whether integrated backscatter (IBS) ultrasound and black-blood magnetic resonance imaging (BB-MRI) can predict the risk of a silent ischemic lesion after CAS. Methods: We performed quantitative analysis of plaque characteristics in carotid arteries using IBS ultrasound and BB-MRI before CAS in 50 patients. We measured IBS values and the signal intensity ratio (SIR) from T1 weighted images of all plaques. We also performed diffusion-weighted (DWI) MRI of the brain before and after CAS. Results: In the patient group that was positive (n = 19) for newly appearing ipsilateral silent ischemic lesions (Nisil), relative unstable component area (%UCA) evaluated by IBS analysis (60.2 ± 23.4% and 35.3 ± 19.2%, p < 0.001) and SIR (1.40 ± 0.19 and 1.18 ± 0.25, p < 0.01) in most stenotic lesions were higher than in the Nisil-negative group (n = 31). From the analysis of receiver operating characteristic curves, 50% of the %UCA measured by IBS and an SIR of 1.25 measured by BB-MRI were the most reliable cutoff values for predicting Nisil. In multivariate logistic regression analysis, the independent predictors of Nisil were SIR (p = 0.030), the CRP level (p = 0.041) and the %UCA measured by IBS (p = 0.049). Conclusions: Quantitative tissue characterization of carotid plaques using IBS ultrasound and BB-MRI was useful to predict Nisil after CAS. The plaque components in carotid arteries should be evaluated by BB-MRI or IBS ultrasound before CAS to improve the clinical outcome of this procedure.

Yukiko Enomoto - One of the best experts on this subject based on the ideXlab platform.

  • Prediction of Silent Ischemic Lesions after Carotid Artery Stenting Using Virtual Histology Intravascular Ultrasound
    Cerebrovascular diseases (Basel Switzerland), 2011
    Co-Authors: Kiyofumi Yamada, Shinichi Yoshimura, Masanori Kawasaki, Yukiko Enomoto, Kyohei Takano, Takahiko Asano, Shinya Minatoguchi, Toru Iwama
    Abstract:

    Background: A major concern with carotid artery stenting (CAS) is the potential for cerebral embolism. The purpose of this study was to determine whether virtual histology intravascular ultrasound (VH-IVUS) can predict the risk of a silent ischemic lesion after CAS. Methods: We performed CAS in 45 patients with carotid stenosis. Before CAS, we assessed plaque characteristics by VH-IVUS. We also performed diffusion-weighted magnetic resonance imaging of the brain before and after CAS to detect newly appearing ipsilateral silent ischemic lesions (Nisil). Results: In the patient group that was positive for Nisil (P group: n = 18), the relative fibrofatty (FF) area identified by VH-IVUS in 5 cross-sections including the most stenotic lesion was significantly larger than that in areas of the Nisil-negative group (N group: n = 27; 32.7 ± 13.2 and 18.3 ± 9.8%, respectively; p Conclusions: Quantitative tissue characterization of atherosclerotic lesions of carotid arteries using VH-IVUS was useful to predict Nisil after CAS. However, the positive predictive value determined by VH-IVUS was not superior to that determined by a noninvasive method.

  • Embolic complications after carotid artery stenting or carotid endarterectomy are associated with tissue characteristics of carotid plaques evaluated by magnetic resonance imaging.
    Atherosclerosis, 2011
    Co-Authors: Kiyofumi Yamada, Shinichi Yoshimura, Masanori Kawasaki, Yukiko Enomoto, Takahiko Asano, Shinya Minatoguchi, Akira Hara, Toru Iwama
    Abstract:

    Background: Unstable carotid plaques are associated with an increased incidence of embolic complications after carotid artery stenting (CAS) or carotid endarterectomy (CEA). The aim of this study was to elucidate the relationship between the tissue components of carotid plaques and the incidence of new ipsilateral silent ischemic lesions (Nisil) after CAS or CEA. Methods: We performed CAS in 56 patients and CEA in 25 patients. We also performed quantitative analyses of carotid plaque characteristics before treatment using T1 weighted black-blood magnetic resonance imaging (BB-MRI). The signal intensity ratio (SIR) was defined as the ratio of signal intensity evaluated by BB-MRI in carotid plaques to that of sternocleidomastoid muscle. According to criteria that we and other investigators previously reported, an SIR ≥ 1.25 was defined as “high”. Nisil were evaluated by diffusion-weighted imaging of MRI before and after CAS or CEA. Results: In the high SIR group, the incidence of Nisil was significantly greater after CAS than after CEA (61% vs 13%, respectively, p = 0.006), whereas there were no significant difference in Nisil after the two procedures when the SIR was

  • Prediction of silent ischemic lesions after carotid artery stenting using integrated backscatter ultrasound and magnetic resonance imaging
    Atherosclerosis, 2009
    Co-Authors: Kiyofumi Yamada, Shinichi Yoshimura, Masanori Kawasaki, Yukiko Enomoto, Takahiko Asano, Shinya Minatoguchi, Toru Iwama
    Abstract:

    Objective: A major concern with carotid artery stenting (CAS) is the potential for cerebral embolism. The purpose of this study was to determine whether integrated backscatter (IBS) ultrasound and black-blood magnetic resonance imaging (BB-MRI) can predict the risk of a silent ischemic lesion after CAS. Methods: We performed quantitative analysis of plaque characteristics in carotid arteries using IBS ultrasound and BB-MRI before CAS in 50 patients. We measured IBS values and the signal intensity ratio (SIR) from T1 weighted images of all plaques. We also performed diffusion-weighted (DWI) MRI of the brain before and after CAS. Results: In the patient group that was positive (n = 19) for newly appearing ipsilateral silent ischemic lesions (Nisil), relative unstable component area (%UCA) evaluated by IBS analysis (60.2 ± 23.4% and 35.3 ± 19.2%, p < 0.001) and SIR (1.40 ± 0.19 and 1.18 ± 0.25, p < 0.01) in most stenotic lesions were higher than in the Nisil-negative group (n = 31). From the analysis of receiver operating characteristic curves, 50% of the %UCA measured by IBS and an SIR of 1.25 measured by BB-MRI were the most reliable cutoff values for predicting Nisil. In multivariate logistic regression analysis, the independent predictors of Nisil were SIR (p = 0.030), the CRP level (p = 0.041) and the %UCA measured by IBS (p = 0.049). Conclusions: Quantitative tissue characterization of carotid plaques using IBS ultrasound and BB-MRI was useful to predict Nisil after CAS. The plaque components in carotid arteries should be evaluated by BB-MRI or IBS ultrasound before CAS to improve the clinical outcome of this procedure.