scholarly journals Morphometry of the Entire Internal Carotid Artery on CT Angiography

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 832
Author(s):  
Radu Andrei Baz ◽  
Cristian Scheau ◽  
Cosmin Niscoveanu ◽  
Petru Bordei
Keyword(s):  
Ct Angiography ◽  
Internal Carotid ◽  
Neck Region ◽  
Anthropometric Parameters ◽  
Measuring Point ◽  
A Value ◽  
Collateral Artery ◽  
Steep Decline ◽  
Carotid Vessels ◽  
Ophthalmic Branch

Background and Objectives: Knowledge of the internal carotid artery’s (ICA) morphometric features is influential in outlining surgical and minimally invasive procedures in the neurovascular field. Many studies have shown divisive numbers regarding the ICA’s caliber, with the measuring point of the artery sometimes differing. This study presents ICA dimensions based on computed tomography angiography in each of its seven segments as per Bouthillier’s classification, correlating vascular dimensions with anthropometric parameters. Materials and Methods: A thorough CT angiography analysis was performed on 70 patients with internal carotid vessels unaffected by atherosclerotic disease. The extracranial part of the ICA was measured in four locations—carotid bulb, post-bulbar dilation, at its cervical midpoint, and below its entrance into the carotid foramen. Single landmarks were used for measurements in the intracranial segments. ICA length was assessed in the neck region and also in the cranial cavity. Craniometric measurements were performed on sagittal and coronal CT reconstructions. Patient height was taken into consideration. Results: The largest ICA portion is near its origin in the carotid sinus area (7.59 ± 1.00 mm), with a steep decline in caliber following its extracranial course. Distal ICA presented values somewhat similar to its proximal intracranial segment diameters (4.67 ± 0.47 mm). Dimensions of the ICA in the intracranial segments start from a value of 4.53 ± 0.47 mm and decrease by approximately 40% when reaching the origin of the middle cerebral artery (2.71 ± 0.37 mm), showing a marked decrease in caliber after the emergence of the most critical collateral artery, the ophthalmic branch. The length of the ICA varies between genders, with the male ICA being about 10 mm longer in total length than female ICA; this difference is also correlated with patient height and skull dimensions. Conclusions: Both intra- and extracranial ICA have variable dimensions and length related to gender and anthropometric parameters, with no significant differences obtained concerning side or age.

Carotid Duplex Velocity Criteria Revisited for the Diagnosis of Carotid In-Stent Restenosis

Vascular ◽  
2007 ◽  
Vol 15 (3) ◽  
pp. 119-125 ◽  
Author(s):  
Ali F. AbuRahma ◽  
Damian Maxwell ◽  
Kris Eads ◽  
Sarah K. Flaherty ◽  
Tabitha Stutler
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Ct Angiography ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Carotid Angiography ◽  
Residual Stenosis ◽  
Stent Restenosis ◽  
The Mean ◽  
In Stent Restenosis

Carotid percutaneous transluminal angioplasty/stenting has become an accepted treatment modality for carotid artery stenosis in high-risk patients. There has been an ongoing debate regarding which duplex ultrasound (DUS) criteria to use to determine the rate of in-stent restenosis. This prospective study revisits DUS criteria for determining the rate of in-stent restenosis. In analyzing a subset of 12 patients (pilot study) who had both completion carotid angiography and DUS within 30 days, 10 patients with normal post-stenting carotid angiography (< 30% residual stenosis) had peak systolic velocities (PSVs) of the stented internal carotid artery (ICA) of ≤ 155 cm/s and two patients with ≥ 30% residual stenosis had internal carotid artery (ICA) PSVs of > 155 cm/s. Eighty-three patients who underwent carotid stenting as part of clinical trials were analyzed. All patients underwent post-stenting carotid DUS that was done at 1 month and every 6 months thereafter. PSVs and end-diastolic velocities of the ICA and common carotid artery were recorded. Patients with PSVs of the ICA of > 140 cm/s underwent carotid computed tomographic (CT) angiography. The perioperative stroke rate was 1.2%. When the old DUS velocity criteria for nonstented carotid arteries were applied, 54% of patients had ≥ 30% restenosis (PSV of > 120 cm/s), but when our new proposed DUS velocity criteria for stented arteries were applied (PSV of > 155 cm/s), 33% had ≥ 30% restenosis at a mean follow-up of 18 months ( p = .007). The mean PSVs for patients with normal stented carotid arteries based on CT angiography, were 122 cm/s versus 243 cm/s for ≥ 30% restenosis and 113 cm/s versus 230 cm/s for ≥ 30% restenosis based on our new criteria. The mean PSVs of in-stent restenosis of 30 to < 50%, 50 to < 70%, and 70 to 99%, based on CT angiography, were 205 cm/s, 264 cm/s, and 435 cm/s, respectively. Receiver operating curve analysis demonstrated that an ICA PSV of > 155 cm/s was optimal for detecting ≥ 30% in-stent restenosis, with a sensitivity of 100%, a specificity of 90%, a positive predictive value of 74%, and a negative predictive value of 100%. The currently used carotid DUS velocity criteria overestimated the incidence of in-stent restenosis. We propose new velocity criteria for the ICA PSV of > 155 cm/s to define ≥ 30% in-stent restenosis.

scholarly journals Thrombosis and spontaneous recanalization of a giant intracranial aneurysm: diagnostic and management pearls in a pediatric patient

2015 ◽  
Vol 15 (1) ◽  
pp. 78-81 ◽  
Author(s):  
Ali Kooshkabadi ◽  
Brian Jankowitz ◽  
Phillip A. Choi ◽  
Gregory M. Weiner ◽  
Stephanie Greene
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Intracranial Aneurysm ◽  
Ct Angiography ◽  
Pediatric Patient ◽  
Internal Carotid ◽  
Giant Aneurysm ◽  
Spontaneous Thrombosis ◽  
Giant Intracranial Aneurysm ◽  
Diagnostic Capability

The authors present the case of a boy who was successfully managed through the spontaneous thrombosis of a cavernous internal carotid artery (ICA) aneurysm, the subsequent occlusion of the ICA, its recanalization, and ultimate endovascular sacrifice, using only two angiograms because of the diagnostic capability of CT angiography. Spontaneous recanalization of the ICA following occlusion in the setting of a giant aneurysm has not been previously reported.

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

Medicine ◽  
2017 ◽  
Vol 96 (5) ◽  
pp. e5722 ◽  
Author(s):  
Ji Man Hong ◽  
Sung Eun Lee ◽  
Seong-Joon Lee ◽  
Jin Soo Lee ◽  
Andrew M. Demchuk
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Ct Angiography ◽  
Internal Carotid ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Internal Carotid Artery Occlusion

Three-dimensional spiral CT angiography in the detection of cerebral aneurysm

1998 ◽  
Vol 39 (3) ◽  
pp. 233-238 ◽  
Author(s):  
M. Strayle-Batra ◽  
M. Skalej ◽  
A. K. Wakhloo ◽  
U. Ernemann ◽  
R. Klier ◽  
...  
Keyword(s):  
3D Reconstruction ◽  
Ct Angiography ◽  
Internal Carotid ◽  
Three Dimensional ◽  
Spatial Relationship ◽  
Spiral Ct ◽  
Posterior Communicating Artery ◽  
Close Spatial Relationship ◽  
Spiral Ct Angiography ◽  
Acute Subarachnoid Hemorrhage

Purpose: The value of CT angiography in the detection and evaluation of aneurysms was compared to digital subtraction angiography (DSA) Material and Methods: Seventeen patients with acute subarachnoid hemorrhage (SAH) or with known or suspected aneurysm were investigated by means of spiral CT angiography, which included 3D reconstruction. These findings were compared with those at DSA Results: In 16 patients, 20 aneurysms were found; the remaining patient had an ectatic vessel that simulated an aneurysm. Seventeen of the angiographically proved aneurysms were detected at CT angiography (sensitivity 85%). One further aneurysm was identified retrospectively as the result of greater experience in the method. All the aneurysms that escaped detection at CT were 3 mm in size. All the vessels of the circle of Willis, except for the posterior communicating artery, were properly evaluated at CT angiography. Difficulties were encountered in assessing the posterior communicating artery and the extradural segment of the internal carotid artery owing to their close spatial relationship to the bony structures of the skull base and the cavernous sinus Conclusion: CT angiography is a low-risk technique with a low level of invasiveness that is useful in following up known aneurysms. The 3D reconstruction yields further topographic information that helps in the planning of endovascular or surgical intervention. The facility for rotating the reconstructed vessels and displaying them from different angles is of particular value in cases difficult to assess at angiography

Rifled carotid: Internal carotid artery thrombosis from prolonged carrying of a military rifle

2019 ◽  
Vol 165 (6) ◽  
pp. e2-e2
Author(s):  
Faiz MH Ahmad ◽  
S K Nanda ◽  
S R ◽  
D S Grewal
Keyword(s):  
Carotid Artery ◽  
Blunt Trauma ◽  
Internal Carotid ◽  
Complete Recovery ◽  
Limb Weakness ◽  
Carotid Artery Thrombosis ◽  
Artery Thrombosis ◽  
Prolonged Duration ◽  
Neurological Presentation ◽  
Carotid Vessels

BackgroundTraumatic carotid artery thrombosis is uncommon and it usually results from penetrating injuries and less commonly secondary to blunt trauma. It can lead to delayed clinical presentation, which leads to delay in the diagnosis. Soldiers in combat scenario also can present with such an illness, which results from varied modes of injuries. Our case illustrates an unusual cause of carotid thrombosis.Case presentationOur patient is a 37-year-old soldier who developed neck pain and headache following a 5 km training run with rifle on the shoulder and subsequently developed left upper limb weakness and evaluation revealed extracranial right internal carotid thrombosis. He was managed with anticoagulants and antiplatelets with complete resolution of the thrombosis and complete recovery of the weakness.ConclusionBlunt trauma to the neck in the form of carrying a rifle for a prolonged duration can result in injury to the carotid vessels leading to delayed neurological presentation. Educating the troops regarding such a mode of illness will prevent such a catastrophic nature of vascular injury resulting in ischaemic stroke.

Abstract T P171: Clinical and Imaging Features Associated with Intracranial Internal Carotid Artery Calcifications in Patients with Ischemic Stroke

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Arda Yilmaz ◽  
Erhan Akpinar ◽  
Mehmet A Topcuoglu ◽  
Ethem M Arsava
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Ischemic Stroke ◽  
Ct Angiography ◽  
Internal Carotid ◽  
Large Artery ◽  
Stroke Subtype ◽  
History Of ◽  
Artery Disease ◽  
Contrast Ct

Background: Intracranial internal carotid artery calcifications (ICAC), a radiologic feature frequently detected on imaging studies, have been shown to be associated with future stroke risk in population-based studies. The clinical significance of this observation among patients with ischemic stroke is, on the other hand, less clear. In this study we sought to identify features associated with ICAC burden in a consecutive series of ischemic stroke patients. Methods: The burden of ICAC was determined separately on non-contrast CT and CT-angiography by semi-quantitative scoring algorithms. The distribution of vascular risk factors, etiologic stroke subtype and calcification burden in other craniocervical arteries were assessed among patients with no ICAC, mild-moderate ICAC and severe ICAC. Results: Of the 319 patients included into the study, 28% had no ICAC, 35% had mild-moderate ICAC and 37% hade severe ICAC on CT-angiography source images. The corresponding figures were 22%, 38% and 41%, respectively, when the ratings were performed on non-contrast CT. Overall non-contrast CT and CT-angiography based ratings were highly correlated (r=0.90, p<0.001). ICAC burden was significantly associated with older age, history of hypertension, diabetes mellitus, coronary artery disease and atrial fibrillation, higher prevalence of large artery atherosclerosis and cardio-aortic embolism as the underlying stroke subtype and presence of calcifications in other craniocervical vessels. Multivariate analyses revealed age, history of diabetes mellitus and coronary artery disease, together with a stroke etiology of large artery atherosclerosis, as factors independently associated with ICAC burden. Conclusion: ICAC burden as determined either by non-contrast CT or CT-angiography reflects a continuum of atherosclerotic disease involving the carotid arteries together with other craniocervical vascular beds. ICAC is significantly associated with large artery atherosclerosis related stroke and might thereby guide the clinician for therapeutic management and etiologic work-up during the acute period.

scholarly journals Multi-Slice CT Angiography in Diagnosing Total Versus Near Occlusions of the Internal Carotid Artery

Stroke ◽  
2004 ◽  
Vol 35 (1) ◽  
pp. 83-85 ◽  
Author(s):  
Chi-Jen Chen ◽  
Tsong-Hai Lee ◽  
Hui-Ling Hsu ◽  
Ying-Chi Tseng ◽  
Shinn-Kuang Lin ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Ct Angiography ◽  
Internal Carotid
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