Multidetector computed tomography in the assessment of neurologic complications after carotid endarterectomy

Rationale: Carotid endarterectomy is a surgical procedure to prevent acute ischemic cerebrovascular accidents. Neurologic complications can occur after surgery. Multidetector computed tomography (MDCT) is used for their diagnosis in severely ill patients.Aim: To evaluate the potential of MDCT in the...

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Main Authors: M. V. Vishnyakova Jr., R. N. Lar'kov, M. V. Vishnyakova
Format: Article
Language:Russian
Published: MONIKI 2017-06-01
Series:Alʹmanah Kliničeskoj Mediciny
Subjects:
Online Access:https://www.almclinmed.ru/jour/article/view/542
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author M. V. Vishnyakova Jr.
R. N. Lar'kov
M. V. Vishnyakova
author_facet M. V. Vishnyakova Jr.
R. N. Lar'kov
M. V. Vishnyakova
author_sort M. V. Vishnyakova Jr.
collection DOAJ
description Rationale: Carotid endarterectomy is a surgical procedure to prevent acute ischemic cerebrovascular accidents. Neurologic complications can occur after surgery. Multidetector computed tomography (MDCT) is used for their diagnosis in severely ill patients.Aim: To evaluate the potential of MDCT in the diagnosis of neurologic complications after carotid endarterectomy.Materials and methods: We analyzed the results of radiologic assessments in 15 patients with early postoperative neurologic complications which occurred after surgery for internal carotid artery occlusion (595 patients underwent surgery). In stable patients, brain magnetic resonance imaging (MRI) was performed (T1, T2, FLAIR, DWI modes) with non-contrast MR angiography. In critically ill patients, brain computed tomography, computed tomographic angiography and perfusion computed tomography were performed.Results: Ischemic neurologic complications were found in 11 patients. One patient had no clinical manifestation of an ischemic stroke, and acute stage signs were found in his routine brain MDCT. In 9 patients with acute brain ischemia, MDCT (n = 6) and MRI (n = 3) results were specific for this diagnosis, with no diagnostic problems. There were problems with the diagnosis of the hyperacute ischemia in 1 patient. In this patient, the complication occurred against a background of abnormal carotid blood flow before surgery, therefore, differential diagnosis between the hyperperfusion syndrome on the intervention side and the hyperacute phase of ischemic insult on the opposite side was performed. Hyperperfusion syndrome and hemorrhagic strokes were observed in 4 patients.Conclusion: The most difficult for diagnosis by MDCT is the hyperacute phase of brain ischemia. Further studies are necessary in the area of diagnosis of postoperative complications, with the search for potential specific diagnostic criteria.
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spelling doaj.art-a39c871542014d99bc3f9add6b65dad72022-12-21T22:21:03ZrusMONIKIAlʹmanah Kliničeskoj Mediciny2072-05052587-92942017-06-0145321822410.18786/2072-0505-2017-45-3-218-224450Multidetector computed tomography in the assessment of neurologic complications after carotid endarterectomyM. V. Vishnyakova Jr.0R. N. Lar'kov1M. V. Vishnyakova2Moscow Regional Research and Clinical Institute (MONIKI)Moscow Regional Research and Clinical Institute (MONIKI)Moscow Regional Research and Clinical Institute (MONIKI)Rationale: Carotid endarterectomy is a surgical procedure to prevent acute ischemic cerebrovascular accidents. Neurologic complications can occur after surgery. Multidetector computed tomography (MDCT) is used for their diagnosis in severely ill patients.Aim: To evaluate the potential of MDCT in the diagnosis of neurologic complications after carotid endarterectomy.Materials and methods: We analyzed the results of radiologic assessments in 15 patients with early postoperative neurologic complications which occurred after surgery for internal carotid artery occlusion (595 patients underwent surgery). In stable patients, brain magnetic resonance imaging (MRI) was performed (T1, T2, FLAIR, DWI modes) with non-contrast MR angiography. In critically ill patients, brain computed tomography, computed tomographic angiography and perfusion computed tomography were performed.Results: Ischemic neurologic complications were found in 11 patients. One patient had no clinical manifestation of an ischemic stroke, and acute stage signs were found in his routine brain MDCT. In 9 patients with acute brain ischemia, MDCT (n = 6) and MRI (n = 3) results were specific for this diagnosis, with no diagnostic problems. There were problems with the diagnosis of the hyperacute ischemia in 1 patient. In this patient, the complication occurred against a background of abnormal carotid blood flow before surgery, therefore, differential diagnosis between the hyperperfusion syndrome on the intervention side and the hyperacute phase of ischemic insult on the opposite side was performed. Hyperperfusion syndrome and hemorrhagic strokes were observed in 4 patients.Conclusion: The most difficult for diagnosis by MDCT is the hyperacute phase of brain ischemia. Further studies are necessary in the area of diagnosis of postoperative complications, with the search for potential specific diagnostic criteria.https://www.almclinmed.ru/jour/article/view/542carotid endarterectomyneurologic complicationsdiagnosticscomputed tomography
spellingShingle M. V. Vishnyakova Jr.
R. N. Lar'kov
M. V. Vishnyakova
Multidetector computed tomography in the assessment of neurologic complications after carotid endarterectomy
Alʹmanah Kliničeskoj Mediciny
carotid endarterectomy
neurologic complications
diagnostics
computed tomography
title Multidetector computed tomography in the assessment of neurologic complications after carotid endarterectomy
title_full Multidetector computed tomography in the assessment of neurologic complications after carotid endarterectomy
title_fullStr Multidetector computed tomography in the assessment of neurologic complications after carotid endarterectomy
title_full_unstemmed Multidetector computed tomography in the assessment of neurologic complications after carotid endarterectomy
title_short Multidetector computed tomography in the assessment of neurologic complications after carotid endarterectomy
title_sort multidetector computed tomography in the assessment of neurologic complications after carotid endarterectomy
topic carotid endarterectomy
neurologic complications
diagnostics
computed tomography
url https://www.almclinmed.ru/jour/article/view/542
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AT mvvishnyakova multidetectorcomputedtomographyintheassessmentofneurologiccomplicationsaftercarotidendarterectomy