Acute Intracranial Internal Carotid Artery Occlusion: Extension and Location of the Thrombus As an Influencing Factor in Computed Tomography Angiography Findings

Overview

Journal Eur J Radiol Open

Specialty Radiology

Date 2022 Dec 23

PMID 36561421

Authors

Miriam Fernandez-Gomez

Felix Gallo-Pineda

Carlos Hidalgo-Barranco

Laura Amaya-Pascasio

Cristina delToro-Perez

Patricia Martinez-Sanchez

Gracia Castro-Luna

Affiliations

Soon will be listed here.

Abstract

Purpose: Acute intracranial internal carotid artery (ICA) occlusion can mimic an extracranial affectation on Computed Tomography angiography (CTA). This fact could be explained by the extension of the thrombus in the ICA concerning its arterial branches. This study aims to determine how this factor may influence imaging findings.

Methods: A retrospective study was conducted from a single-center database of patients undergoing mechanical thrombectomy due to ICA occlusion between October 2017 and March 2022 (n = 77). Patients with acute intracranial ICA occlusion were included (n = 29) and divided into two groups, according to ICA opacification on CTA: the discernible extracranial ICA or group D, and the pseudo-occlusion or group P. Patency of posterior communicating, anterior choroidal, and ophthalmic arteries on digital subtraction angiography were collected to determine thrombus extension. Sensitivity and specificity were calculated for CTA.

Results: Significant differences were found in DSA between group P (n = 17) and group D (n = 12) in the frequency of patency of major artery branches: the presence of posterior communicating (PCOM) and anterior choroidal arteries (AChA) was observed in 2 patients in group P vs. 10 in group D (p < 0.001); whereas the patency of the ophthalmic artery (OA) was visualized in 10 patients in group P vs. 12 in group D, p = 0.023). For the diagnosis of isolated intracranial ICA occlusion, CTA had a sensitivity of 43.5% and a specificity of 97.2%.

Conclusions: The location and extent of the thrombus in the intracranial ICA concerning major artery branches may influence CTA findings.

Citing Articles

Outcome of acute ischemic stroke with absent opacification of the cervical internal carotid artery at CT-angiography after endovascular treatment.

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Accuracy of Computed Tomography Angiography for Diagnosing Extracranial Mural Lesions in Patients with Acute Internal Carotid Artery Occlusion: Correlation with Digital Subtraction Angiography.

Fernandez-Gomez M, Gallo-Pineda F, Hidalgo-Barranco C, Castro-Luna G, Martinez-Sanchez P J Pers Med. 2023; 13(7).

PMID: 37511782 PMC: 10381416. DOI: 10.3390/jpm13071169.

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