Contrast‐enhanced transoral carotid ultrasonography for the evaluation of a long stenotic lesion in the internal carotid artery

ABSTRACTIntroductionTransradial angiography (TRA) has received considerable attention in the field of neurointervention owing to its advantages over transfemoral approaches. However, the difficulty of left internal carotid artery (ICA) catheterization under certain anatomical conditions of the aortic arch and its branches is a limitation of TRA. This study aimed to investigate the anatomical predictors of successful catheterization of the left ICA in TRA.Materials and MethodsFrom January 2020 to October 2020, 640 patients underwent TRA at a single institute. Among them, 263 consecutive patients who were evaluated by contrast-enhanced MRI before TRA were included in our study and assigned to success and failure groups, according to whether left ICA catheterization was possible or not. Anatomical predictors that may affect the success of left ICA catheterization in TRA were investigated for the purposes of our study.ResultsThe multivariable analysis included variables that demonstrated significant univariate associations with ICA catherization (P<0.0001). Variables included in the model were the type of aortic arch, height of right subclavian artery, turn-off angle of the left common carotid artery (CCA), distance between innominate artery to the left CCA, angulation of right subclavian artery, and angulation of the left CCA, which we identified as significant predictors of left ICA catheterization.ConclusionSuccess of left ICA catheterization in TRA was related to the vascular geometry of the aortic arch and its branches. Evaluating the anatomical predictors identified in this study using pre-procedure imaging may enhance the success rate of left ICA catheterization in TRA.

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Can contrast-enhanced ultrasound with second-generation contrast agents replace computed tomography angiography for distinguishing between occlusion and pseudo-occlusion of the internal carotid artery?

Clinics ◽

10.6061/clinics/2015(01)01 ◽

2015 ◽

Vol 70 (1) ◽

pp. 1-6 ◽

Cited By ~ 9

Author(s):

CA Ventura ◽

ES da Silva ◽

GG Cerri ◽

P Puech-Leao ◽

A Tachibana ◽

...

Keyword(s):

Computed Tomography ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Contrast Agents ◽

Computed Tomography Angiography ◽

Second Generation ◽

Internal Carotid ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced

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Why a standard contrast-enhanced MRI might be useful in intracranial internal carotid artery stenosis

The Neuroradiology Journal ◽

10.1177/1971400916638354 ◽

2016 ◽

Vol 29 (3) ◽

pp. 208-212 ◽

Cited By ~ 1

Author(s):

Maximilian Oeinck ◽

Christoph Rozeik ◽

Jens Wattchow ◽

Stephan Meckel ◽

Manuel Schlageter ◽

...

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Carotid Artery Stenosis ◽

Internal Carotid ◽

Internal Carotid Artery Stenosis ◽

Artery Stenosis ◽

Enhanced Mri ◽

Contrast Enhanced ◽

Contrast Enhanced Mri

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Semiautomatic segmentation and stenosis quantification of 3D contrast-enhanced MR angiograms of the internal carotid artery

Magnetic Resonance in Medicine ◽

10.1002/mrm.20020 ◽

2004 ◽

Vol 51 (4) ◽

pp. 753-760 ◽

Cited By ~ 19

Author(s):

Cornelis M. van Bemmel ◽

Max A. Viergever ◽

Wiro J. Niessen

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Semiautomatic Segmentation ◽

Contrast Enhanced ◽

Stenosis Quantification

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Internal Carotid Artery Stenosis: Accuracy of Subjective Visual Impression for Evaluation with Digital Subtraction Angiography and Contrast-enhanced MR Angiography

Radiology ◽

10.1148/radiol.2441060749 ◽

2007 ◽

Vol 244 (1) ◽

pp. 213-222 ◽

Cited By ~ 13

Author(s):

Jean Marie U-King-Im ◽

Martin J. Graves ◽

Justin J. Cross ◽

Nicholas J. Higgins ◽

Josephine Wat ◽

...

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Digital Subtraction Angiography ◽

Carotid Artery Stenosis ◽

Mr Angiography ◽

Internal Carotid ◽

Internal Carotid Artery Stenosis ◽

Digital Subtraction ◽

Visual Impression ◽

Contrast Enhanced

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Transoral Carotid Ultrasonography Is Useful for Detection and Follow-Up of Extracranial Internal Carotid Artery Dissecting Aneurysm

Cerebrovascular Diseases ◽

10.1159/000103619 ◽

2007 ◽

Vol 24 (1) ◽

pp. 144-146 ◽

Cited By ~ 4

Author(s):

Yusuke Yakushiji ◽

Yukinori Takase ◽

Masafumi Kosugi ◽

Hiroharu Inoue ◽

Akira Uchino ◽

...

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Dissecting Aneurysm ◽

Extracranial Internal Carotid Artery ◽

Carotid Ultrasonography

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Abstract TMP44: Contrast Enhanced Ultrasound Can Detect Small Disruption of Carotid Plaques Related to Symptomatic Internal Carotid Artery Stenosis

Stroke ◽

10.1161/str.47.suppl_1.tmp44 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Soichiro Abe ◽

Kozue Saito ◽

Hatsue Ishibashi-Ueda ◽

Shuichi Tonomura ◽

Kota Mori ◽

...

Keyword(s):

Ischemic Stroke ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Carotid Artery Stenosis ◽

Carotid Plaque ◽

Internal Carotid ◽

Color Doppler ◽

Internal Carotid Artery Stenosis ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced

Background: The ulcerated atheroma of the carotid artery is a risk factor of ipsilateral ischemic stroke. Contrast-enhanced ultrasound (CEUS) is a novel noninvasive technique useful for evaluating the morphology of carotid plaques, and can detect small disruptions on plaque surface. However, it remains unclear whether the disrupted carotid plaque detected by CEUS is related to the symptomatic internal carotid artery stenosis (ICS). Methods: A total of 79 ICS patients who underwent carotid endarterectomy (CEA) were enrolled from July 2010 to July 2015. Before operation, ICA lesions were examined by color Doppler ultrasound (CDUS) and CEUS using perflubutane. The ulceration was diagnosed when both of the color Doppler signal on CDUS and the pooling of microbubbles on CEUS were observed within the plaque. The disruption was diagnosed only by CEUS when microbubbles pooled through the fissured surface, unlike the linear delineation of neovessels. We validated findings on ultrasound compared with the histopathological findings of ulceration and present/recent plaque rupture. The associations between ulceration/disruption on ultrasound and symptomatic ICS (with a history of ipsilateral transient ischemic attack and/or ischemic stroke) were investigated. Results: Of 79 subjects (mean age 71.2±6.8 years old, 78 men), 55 had symptomatic ICS. The ulceration by CEUS and CDUS was recognized in 20 patients (25%), and the disruption on plaque surface was seen by CEUS solitary in 26 patients (33%). The sensitivity and specificity of detecting plaque ulceration or disruption using CEUS compared with histopathological findings were 0.57 (45/66) and 1.00 (13/13), respectively. The detection rate of ulceration or disruption using CEUS was higher in symptomatic ICS than in asymptomatic ICS (66% vs 42%, P=0.049). Compared to plaques without ulceration/disruption on ultrasound, prevalence of symptomatic ICS was higher in plaques with the disruption (88% vs 58%, P=0.01), whereas it was similar in plaques with the ulceration (65% vs 58%, P=0.77) Conclusion: Small disruptions on carotid plaque surface detected by CEUS were significantly related to symptomatic ICS and this results may help the detailed assessment of plaque vulnerability.

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