308 739

Cited 4 times in

Distinctive patterns on CT angiography characterize acute internal carotid artery occlusion subtypes

Authors
Hong, JM  | Lee, SE  | Lee, SJ  | Lee, JS  | Demchuk, AM
Citation
Medicine, 96(5). : e5722-e5722, 2017
Journal Title
Medicine
ISSN
0025-79741536-5964
Abstract
Noninvasive computed tomography angiography (CTA) is widely used in acute ischemic stroke, even for diagnosing various internal carotid artery (ICA) occlusion sites, which often need cerebral digital subtraction angiography (DSA) confirmation. We evaluated whether clinical outcomes vary depending on the DSA-based occlusion sites and explored correlating features on baseline CTA that predict DSA-based occlusion site.We analyzed consecutive patients with acute ICA occlusion who underwent DSA and CTA. Occlusion site was classified into cervical, cavernous, petrous, and carotid terminus segments by DSA confirmation. Clinical and radiological features associated with poor outcome at 3 months (3-6 of modified Rankin scale) were analyzed. Baseline CTA findings were categorized according to carotid occlusive shape (stump, spearhead, and streak), presence of cervical calcification, Willisian occlusive patterns (T-type, L-type, and I-type), and status of leptomeningeal collaterals (LMC).We identified 49 patients with occlusions in the cervical (n = 17), cavernous (n = 22), and carotid terminus (n = 10) portions: initial NIH Stroke Scale (11.4 +/- 4.2 vs 16.1 +/- 3.7 vs 18.2 +/- 5.1: P < 0.001), stroke volume (27.9 +/- 29.6 vs 127.4 +/- 112.6 vs 260.3 +/- 151.8 mL: P < 0.001), and poor outcome (23.5 vs 77.3 vs 90.0%: P < 0.001). Cervical portion occlusion was characterized as rounded stump (82.4%) with calcification (52.9%) and fair LMC (94.1%): cavernous as spearhead occlusion (68.2%) with fair LMC (86.3%) and no calcification (95.5%): and terminus as streak-like occlusive pattern (60.0%) with poor LMC (60.0%), and no calcification (100%) on CTA.Our study indicates that acute ICA occlusion can be subtyped into cervical, cavernous, and terminus. Distinctive findings on initial CTA can help differentiate ICA-occlusion subtypes with specific characteristics.
MeSH

DOI
10.1097/MD.0000000000005722
PMID
28151850
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Neurology
Journal Papers > School of Medicine / Graduate School of Medicine > Emergency Medicine
Ajou Authors
이, 성은  |  이, 성준  |  이, 진수  |  홍, 지만
Full Text Link
Files in This Item:
28151850.pdfDownload
Export

qrcode

해당 아이템을 이메일로 공유하기 원하시면 인증을 거치시기 바랍니다.

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse