Multi-slice CT angiography in evaluation of extracranial–intracranial bypass

• Published in: European journal of radiology 2004-12, Vol.52 (3), p.217-220
• Main Authors: Teksam, Mehmet, McKinney, Alexander, Truwit, Charles L.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Angiography - methods; Angiography, Digital Subtraction; Biological and medical sciences; Cardiovascular system; Cerebral Arterial Diseases - surgery; Cerebral Revascularization; Constriction, Pathologic - diagnostic imaging; Constriction, Pathologic - surgery; Contrast Media; CT angiography; Extracranial–intracranial bypass; Female; Follow-Up Studies; Humans; Image Processing, Computer-Assisted - methods; Intracranial Aneurysm - surgery; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Middle Cerebral Artery - diagnostic imaging; Middle Cerebral Artery - surgery; Multi-slice CT; Occipital Lobe - blood supply; Posterior Cerebral Artery - diagnostic imaging; Posterior Cerebral Artery - surgery; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Retrospective Studies; Temporal Arteries - diagnostic imaging; Temporal Arteries - surgery; Tomography Scanners, X-Ray Computed; Tomography, X-Ray Computed - methods; Vascular Patency - physiology
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2003.12.003

Multi-slice CT (MSCT) scanners provided significant improvement in vascular applications. In this study, our purpose was to determine the clinical utility of MSCTA in evaluation of extracranial–intracranial (EC-IC) bypass patency. Eleven (4 men and 7 women; mean age, 46 years; age range, 19–68 years) consecutive patients who underwent MSCTA and DSA after EC-IC bypass surgery were evaluated retrospectively. All patients underwent DSA within 3 weeks of MSCTA. The indications for EC-IC bypass were severe stenosis or occlusion of intracranial arteries in seven patients and therapeutic occlusion of intracranial artery for unclippable giant aneurysm in four patients. Ten patients underwent superficial temporal artery (STA)–middle cerebral artery (MCA) bypass and one patient underwent occipital artery–posterior cerebral artery (PCA) bypass. Eight STA–MCA bypasses in six patients were patent on MSCTA which were confirmed on DSA. Two STA–MCA bypasses and one occipital artery–posterior cerebral artery (PCA) bypass were occluded in three patients on MSCTA and DSA. In one patient, minimal stenosis of the STA–MCA bypass was identified on MSCTA and DSA. In 1 patient, STA–MCA bypass was not well seen on MSCTA and suspected for occlusion. DSA identified the occlusion of bypass on this patient. MSCTA seems to be a very promising noninvasive technique in evaluation of EC-IC bypass.