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Cta tia

Waleed Brinjikji, Ronit Agid, Vitor M Pereira
Background and Purpose: Carotid webs are an increasingly recognized cause of acute is-chemic stroke, particularly in younger adults. The optimal medical and surgical strategies for managing these lesions have not been well established. We report a single-center case series of carotid stenting for treatment of symptomatic carotid webs. Materials and Methods: Consecutive patients undergoing stent placement for treatment of symptomatic carotid webs were included. Carotid webs were defined as a thin intraluminal filling defect along the posterior wall of the carotid bulb just beyond the carotid bifurcation on CTA...
April 2018: Interventional Neurology
Anish N Sen, Jared Fridley, Sherly Sebastian, Edward A M Duckworth
BACKGROUND: Intraoperative computed tomography angiography (ICTA) is a novel completion imaging modality for carotid endarterectomy (CEA). No studies exist in the literature describing ICTA use in CEA. OBJECTIVE: To evaluate the feasibility and efficacy of ICTA as a method of immediately evaluating the technical results of CEA. METHODS: Twenty-three consecutive CEAs were performed by a single neurosurgeon over an 8-month period. Of this series, 12 utilized ICTA for completion imaging, 10 utilized duplex ultrasonography (US), and 1 utilized no intraoperative completion imaging...
December 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
X Leng, L Lan, H L Ip, F Fan, S H Ma, K Ma, H Liu, Z Yan, J Liu, J Abrigo, Y O Y Soo, D S Liebeskind, K S Wong, T W Leung
BACKGROUND AND PURPOSE: Leptomeningeal collateral (LMC) status governs the prognosis of large artery occlusive stroke, although factors determining LMC status are not fully elucidated. The aim was to investigate metrics affecting LMC status in such patients by using computational fluid dynamics (CFD) models based on computed tomography angiography (CTA). METHODS: In this cross-sectional study, patients with recent ischaemic stroke or transient ischaemic attack attributed to atherosclerotic M1 middle cerebral artery (MCA) stenosis (50%-99%) were recruited...
February 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
H Baradaran, K Al-Dasuqi, A Knight-Greenfield, A Giambrone, D Delgado, E J Ebani, H Kamel, A Gupta
BACKGROUND: CTA is a widely available imaging examination that may allow the evaluation of high-risk carotid plaque features. PURPOSE: Our aim was to evaluate the association between specific carotid plaque features on CTA and ipsilateral cerebrovascular ischemia. DATA SOURCES: We performed a systematic review of Ovid MEDLINE, Ovid Embase, Scopus, and the Cochrane Library from inception to March 2016 for articles that evaluated the relationship between CTA-detected carotid plaque features and ischemic events, defined as ipsilateral ischemic stroke or transient ischemic attack...
December 2017: AJNR. American Journal of Neuroradiology
Stephen A Johnson, Andrew F Ducruet, Jonathan B Bellotte, Charles E Romero, Robert M Friedlander
BACKGROUND: Rotational vertebral artery occlusion is a rare syndrome characterized by vertebrobasilar insufficiency secondary to position-dependent occlusion of the vertebral artery. Most cases reported in the literature have been attributed to osteophytic compression, either from the occipital condyle or within the transverse foramen. However, vertebral artery dissection secondary to motion in the setting of anomalous anatomy has not been reported. CASE DESCRIPTION: To the authors' knowledge, rotational vertebral artery occlusion and dissection secondary to anomalous entrance into the transverse foramen have never been reported...
December 2017: World Neurosurgery
Anouk D Rozeman, Hajo Hund, Michel Westein, Marieke J H Wermer, Geert J Lycklama À Nijeholt, Jelis Boiten, Robert-Jan Schimsheimer, Ale Algra
OBJECTIVES: Vertebrobasilar stenosis is frequent in patients with posterior circulation stroke and it increases risk of recurrence. We investigated feasibility of duplex ultrasonography (DUS) for screening for extracranial vertebral artery stenosis and compared it with CT angiography (CTA). MATERIALS AND METHODS: We gathered data on 337 consecutive patients who had DUS because of posterior circulation stroke or TIA. Matching CTA studies were retrieved and used as reference...
August 2017: Brain and Behavior
Ali S Haider, Caleb Gottlich, Tijani Osumah, Maryam Alam, Umair Khan, Steven Vayalumkal, Dean Leonard, Richa Thakur, Kennith F Layton
A significant but less recognized cause of ischemic stroke and transient ischemic attack (TIA) is atherosclerosis of the vertebrobasilar system, which accounts for 20% of ischemic strokes. Pathology of the vertebrobasilar system can present significant challenges in determining the course of treatment. Due to the complexity of the vertebrobasilar system, there is slight disagreement about how to approach patients with atherosclerotic pathology of the posterior circulation. Two such approaches are either stenting of the vertebral or basilar artery or aggressive medical management...
May 26, 2017: Curēus
Best Anyama, Daniela Treitl, Jeffery Wessell, Rachele Solomon, Andrew A Rosenthal
Blunt cerebrovascular injury (BCVI) to the carotid artery is a relatively rare injury that is difficult to identify even with imaging. Any symptoms or neurological deficits following blunt neck injury mandate evaluation and consideration of BCVI. In an effort to highlight this issue, we report the case of a 31-year-old male patient who presented with left-sided weakness consistent with transient ischemic attack (TIA) and concussion. The patient's symptoms occurred within 24 hours of a blunt neck injury sustained by a knee strike during a basketball game...
2017: Case Reports in Emergency Medicine
Moni Roy, Ashish Kumar Roy, Jeffrey R DeSanto, Murad Abdelsalam
We present a case of 72-year-old male with reported past medical history of recurrent transient ischemic attacks (TIAs) presenting with myriad of neurological symptoms. Patient was transferred from outlying hospital with complaints of right sided facial droop and dysarthria. Computed tomography angiography (CTA) showed high grade proximal left internal carotid artery (ICA) stenosis along with interesting finding of a free floating thrombus (FFT) in the left ICA. After discussion with the neurosurgical team, our case was treated conservatively with combination of antiplatelet therapy with Aspirin and anticoagulation with Warfarin without recurrence of TIAs or strokes on six-month follow-up...
2017: Case Reports in Medicine
S Sundaram, S Kannoth, B Thomas, P S Sarma, P N Sylaja
BACKGROUND AND PURPOSE: Cervical internal carotid artery occlusion can present with varied clinical manifestations such as transient ischemic attack, stroke, and chronic ocular ischemia, or can be asymptomatic. The outcome in these patients is considerably influenced by cerebral hemodynamic compensatory adaptation of the intracranial collateral pathways. Our aim was to study whether collateral circulation as assessed by CT angiography can predict 3-month outcome and initial stroke severity in patients with symptomatic cervical ICA occlusion...
January 2017: AJNR. American Journal of Neuroradiology
Virginija Gaigalaite, Augenijus Vilimas, Violeta Ozeraitiene, Jurate Dementaviciene, Ricardas Janilionis, Danute Kalibatiene, Saulius Rocka
BACKGROUND: The clinical significance of vertebral artery (VA) hypoplasia is under discussion. The aim of this retrospective study is to evaluate a hypothesis of a possible causal link between VA hypoplasia (VAH) and the incidence of posterior circulation stroke (PCS) or TIA depending on the degree of VAH and vascular risk factors. METHODS: A total of 367 symptomatic (PCS or TIA) and 742 asymptomatic subjects, were selected to participate in the study. The extracranial arteries were examined by ultrasound...
July 26, 2016: BMC Neurology
Markus A Möhlenbruch, Johannes Pfaff, Christian Herweh, Julian Bösel, Timolaos Rizos, Simon Nagel, Peter A Ringleb, Martin Bendszus, Mirko Pham
INTRODUCTION: We present a novel endovascular technique to treat intracranial atherosclerotic stenosis (ICS) with the specific potential to reduce the procedure-related complications which so far limited safety and efficacy of endovascular ICS intervention. METHODS: Six consecutive patients were included in this study with the following criteria of inclusion: (1) failure of dual antiplatelet therapy defined as recurrent TIA or ischemic stroke, (2) presence of ICS of ≥70 %, and (3) endovascular accessibility of the target lesion as judged by CTA or MRA...
September 2016: Neuroradiology
Aike Qiao, Xuan Dai, Jing Niu, Liqun Jiao
Hemodynamic factors may affect the potential occurrence of in-stent restenosis (ISR) after intervention procedure of vertebral artery ostial stenosis (VAOS). The purpose of the present study is to investigate the influence of stent protrusion length in implantation strategy on the local hemodynamics of the VAOS. CTA images of a 58-year-old female patient with posterior circulation transient ischemic attack were used to perform a 3D reconstruction of the vertebral artery. Five models of the vertebral artery before and after the stent implantation were established...
2016: Computer Methods in Biomechanics and Biomedical Engineering
Kenneth C Bilchick, Augustus Mealor, Jorge Gonzalez, Patrick Norton, David Zhuo, Pamela Mason, John D Ferguson, Rohit Malhotra, J Michael Mangrum, Andrew E Darby, John DiMarco, Klaus Hagspiel, John Dent, Christopher M Kramer, George J Stukenborg, Michael Salerno
BACKGROUND: Computed tomography angiography (CTA) can identify and rule out left atrial appendage (LAA) thrombus when delayed imaging is also performed. OBJECTIVE: In patients referred for CTA to evaluate pulmonary vein anatomy before the ablation of atrial fibrillation (AF) or left atrial flutter (LAFL), we sought to determine the effectiveness of a novel clinical protocol for integrating results of CTA delayed LAA imaging into preprocedure care. METHODS: After making delayed imaging of the LAA part of our routine preablation CTA protocol, we integrated early reporting of preablation CTA LAA imaging results into clinical practice as part of a formal protocol in June 2013...
January 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Praful Dalal, Madhumita Bhattacharjee
TIA is a serious condition and a medical emergency requiring immediate evaluation and treatment to prevent a stroke. Confirmation of diagnosis is vital. Medical conditions like hypoglycaemia, migraine etc which mimic TIA should be identified. TIA syndrome in carotid territory needs special evaluation by Duplex sonography to detect significant stenosis (>70%) near bifurcation. Recurrent TIA in the same territory leaves neuro deficit and this needs prevention by appropriate therapy (platelet antiaggregants, anticoagulants, surgical intervention)...
December 2014: Journal of the Association of Physicians of India
J Borst, H A Marquering, M Kappelhof, T Zadi, A C van Dijk, P J Nederkoorn, R van den Berg, A van der Lugt, C B L M Majoie
BACKGROUND AND PURPOSE: Semiautomatic measurement of ICA stenosis potentially increases observer reproducibility. In this study, we assessed the diagnostic accuracy and interobserver reproducibility of a commercially available semiautomatic ICA stenosis measurement on CTA and estimated the agreement among different software packages. MATERIALS AND METHODS: We analyzed 141 arteries from 90 patients with TIA or ischemic stroke. Manual stenosis measurements were performed by 2 neuroradiologists...
October 2015: AJNR. American Journal of Neuroradiology
P-Q Wang, J-J Liu, A-P Wang, G-B Zhang, Z-H Cao, P Wang, P-Y Zhou
OBJECTIVE: To evaluate the recurrent ischemic events and risk factors in patients with symptomatic intracranial artery stenosis. PATIENTS AND METHODS: Patients with acute cerebral infarction or transient ischemia attach (TIA) and intracranial arterial stenosis confirmed through CTA examination, were enrolled from the Department of Neurology. All cases were followed-up regularly and divided into recurrent group and non-recurrent group according to occurrence of cerebrovascular events...
2015: European Review for Medical and Pharmacological Sciences
Leanne K Casaubon, Jean-Martin Boulanger, Dylan Blacquiere, Scott Boucher, Kyla Brown, Tom Goddard, Jacqueline Gordon, Myles Horton, Jeffrey Lalonde, Christian LaRivière, Pascale Lavoie, Paul Leslie, Jeanne McNeill, Bijoy K Menon, Brian Moses, Melanie Penn, Jeff Perry, Elizabeth Snieder, Dawn Tymianski, Norine Foley, Eric E Smith, Gord Gubitz, Michael D Hill, Ev Glasser, Patrice Lindsay
The 2015 update of the Canadian Stroke Best Practice Recommendations Hyperacute Stroke Care guideline highlights key elements involved in the initial assessment, stabilization, and treatment of patients with transient ischemic attack (TIA), ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and acute venous sinus thrombosis. The most notable change in this 5th edition is the addition of new recommendations for the use of endovascular therapy for patients with acute ischemic stroke and proximal intracranial arterial occlusion...
August 2015: International Journal of Stroke: Official Journal of the International Stroke Society
Ido R van den Wijngaard, Ale Algra, Geert J Lycklama À Nijeholt, Jelis Boiten, Marieke J H Wermer, Marianne A A van Walderveen
INTRODUCTION: About 15% of patients with transient ischemic attack (TIA) or minor ischemic stroke have functional impairment after 3 months. We studied the role of whole brain computed tomography perfusion (WB-CTP) in the emergency diagnosis of TIA or minor stroke in predicting disability at 3 months. METHODS: We included patients with ongoing symptoms of a TIA or minor stroke with a National Institutes of Health Stroke Scale (NIHSS) score less than 4 who were evaluated with noncontrast CT (NCCT), CT angiography (CTA), and WB-CTP within 24 hours of symptom onset...
September 2015: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Noritaka Sano, Tetsu Satow, Daisuke Maruyama, Hiroharu Kataoka, Ken-ichi Morita, Hatsue Ishibashi-Ueda, Koji Iihara
OBJECTIVE: This study aimed to elucidate the relationships between preoperative carotid imaging results, histologic characteristics, and surgical treatment outcomes of radiation-induced carotid stenosis (RICS), using control subjects without RICS for comparison. METHODS: We retrospectively reviewed records of 17 patients who underwent carotid revascularization for 22 instances of RICS, including 10 cases of carotid artery stenting (CAS), 11 cases of carotid endarterectomy (CEA), and 1 case of CEA with retrograde CAS, between July 2004 and April 2013...
August 2015: Journal of Vascular Surgery
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