Role of CT Angiography in Detection of Extracranial Carotid and Vertebral Artery Disease in Patients With Acutely Ruptured Intracranial Aneurysms
Introduction: Computed tomography (CT) and CT angiography are standard imaging modalities for suspected acute intracerebral hemorrhage due to ruptured intracranial aneurysms. In this clinical setting, several protocols of computed tomography and CT angiography may be implemented. The standard CT ang...
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| Format: | Article |
| Language: | Russian |
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Scientific Research Institute, Ochapovsky Regional Clinical Hospital no. 1
2023-03-01
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| Series: | Инновационная медицина Кубани |
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| Online Access: | https://www.innovmedkub.ru/jour/article/view/628 |
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| author | E. I. Zyablova V. A. Porhanov V. E. Sinitsyn D. D. Zyablova E. E. Ivanina |
| author_facet | E. I. Zyablova V. A. Porhanov V. E. Sinitsyn D. D. Zyablova E. E. Ivanina |
| author_sort | E. I. Zyablova |
| collection | DOAJ |
| description | Introduction: Computed tomography (CT) and CT angiography are standard imaging modalities for suspected acute intracerebral hemorrhage due to ruptured intracranial aneurysms. In this clinical setting, several protocols of computed tomography and CT angiography may be implemented. The standard CT angiography protocol is limited to intracranial vessels. The extended protocol may also include carotid and vertebral arteries and the aortic arch.Objective: To define the CT angiography role in detection of extracranial carotid and vertebral artery disease and clinical significance of this method for patients with suspected acute intracerebral hemorrhages due to ruptured intracranial aneurysms.Materials and methods: The study included 275 neurosurgical patients with acute nontraumatic intracranial hemorrhages due to ruptured intracranial aneurysms who were treated in Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1 (Krasnodar, Russian Federation) from September 2017 to August 2020. Computed tomography and CT angiography were performed in all patients. The scanned area included both intracranial and extracranial arteries (an arch-to-vertex angiogram) to detect extracranial carotid and vertebral artery diseases such as stenoses, occlusions, tortuosity, and hypoplasia.Results: Atherosclerosis of internal carotid and vertebral arteries was diagnosed in 95 patients (34.5% of the total number of patients included in the study). In 13 (4.7%) patients these stenoses were hemodynamically significant. We identified a high frequency of tortuous carotid and vertebral arteries (122 cases, 44.3%) and vertebral artery hypoplasia (59 cases, 21.5%). The carotid and vertebral artery stenoses and congenital anomalies of vertebral arteries (however, not of carotid arteries) were associated with a higher incidence of unfavorable outcomes after endovascular treatment of intracranial aneurysms.Conclusions: The optimal CT angiography protocol for acute nontraumatic intracranial hemorrhage should focus on the arteries of the head and neck (up to the aortic arch). This protocol shows higher detection rate of concomitant anomalies of carotid and vertebral arteries. These findings are important for planning and successful performance of endovascular treatment for intracranial aneurysms. |
| first_indexed | 2024-03-07T15:35:16Z |
| format | Article |
| id | doaj.art-e5d7b54f135a41998f9e66a0f8d2b529 |
| institution | Directory Open Access Journal |
| issn | 2541-9897 |
| language | Russian |
| last_indexed | 2024-03-07T15:35:16Z |
| publishDate | 2023-03-01 |
| publisher | Scientific Research Institute, Ochapovsky Regional Clinical Hospital no. 1 |
| record_format | Article |
| series | Инновационная медицина Кубани |
| spelling | doaj.art-e5d7b54f135a41998f9e66a0f8d2b5292024-03-05T11:12:32ZrusScientific Research Institute, Ochapovsky Regional Clinical Hospital no. 1Инновационная медицина Кубани2541-98972023-03-0101212810.35401/2541-9897-2023-26-1-21-28357Role of CT Angiography in Detection of Extracranial Carotid and Vertebral Artery Disease in Patients With Acutely Ruptured Intracranial AneurysmsE. I. Zyablova0V. A. Porhanov1V. E. Sinitsyn2D. D. Zyablova3E. E. Ivanina4Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical UniversityScientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical UniversityMedical Scientific and Educational Center of Lomonosov Moscow State UniversityKuban State Medical UniversityKuban State Medical UniversityIntroduction: Computed tomography (CT) and CT angiography are standard imaging modalities for suspected acute intracerebral hemorrhage due to ruptured intracranial aneurysms. In this clinical setting, several protocols of computed tomography and CT angiography may be implemented. The standard CT angiography protocol is limited to intracranial vessels. The extended protocol may also include carotid and vertebral arteries and the aortic arch.Objective: To define the CT angiography role in detection of extracranial carotid and vertebral artery disease and clinical significance of this method for patients with suspected acute intracerebral hemorrhages due to ruptured intracranial aneurysms.Materials and methods: The study included 275 neurosurgical patients with acute nontraumatic intracranial hemorrhages due to ruptured intracranial aneurysms who were treated in Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1 (Krasnodar, Russian Federation) from September 2017 to August 2020. Computed tomography and CT angiography were performed in all patients. The scanned area included both intracranial and extracranial arteries (an arch-to-vertex angiogram) to detect extracranial carotid and vertebral artery diseases such as stenoses, occlusions, tortuosity, and hypoplasia.Results: Atherosclerosis of internal carotid and vertebral arteries was diagnosed in 95 patients (34.5% of the total number of patients included in the study). In 13 (4.7%) patients these stenoses were hemodynamically significant. We identified a high frequency of tortuous carotid and vertebral arteries (122 cases, 44.3%) and vertebral artery hypoplasia (59 cases, 21.5%). The carotid and vertebral artery stenoses and congenital anomalies of vertebral arteries (however, not of carotid arteries) were associated with a higher incidence of unfavorable outcomes after endovascular treatment of intracranial aneurysms.Conclusions: The optimal CT angiography protocol for acute nontraumatic intracranial hemorrhage should focus on the arteries of the head and neck (up to the aortic arch). This protocol shows higher detection rate of concomitant anomalies of carotid and vertebral arteries. These findings are important for planning and successful performance of endovascular treatment for intracranial aneurysms.https://www.innovmedkub.ru/jour/article/view/628ct angiographyaneurysmsubarachnoid hemorrhageatherosclerosis of the brachiocephalic arteriesbrachiocephalic artery anomaly |
| spellingShingle | E. I. Zyablova V. A. Porhanov V. E. Sinitsyn D. D. Zyablova E. E. Ivanina Role of CT Angiography in Detection of Extracranial Carotid and Vertebral Artery Disease in Patients With Acutely Ruptured Intracranial Aneurysms Инновационная медицина Кубани ct angiography aneurysm subarachnoid hemorrhage atherosclerosis of the brachiocephalic arteries brachiocephalic artery anomaly |
| title | Role of CT Angiography in Detection of Extracranial Carotid and Vertebral Artery Disease in Patients With Acutely Ruptured Intracranial Aneurysms |
| title_full | Role of CT Angiography in Detection of Extracranial Carotid and Vertebral Artery Disease in Patients With Acutely Ruptured Intracranial Aneurysms |
| title_fullStr | Role of CT Angiography in Detection of Extracranial Carotid and Vertebral Artery Disease in Patients With Acutely Ruptured Intracranial Aneurysms |
| title_full_unstemmed | Role of CT Angiography in Detection of Extracranial Carotid and Vertebral Artery Disease in Patients With Acutely Ruptured Intracranial Aneurysms |
| title_short | Role of CT Angiography in Detection of Extracranial Carotid and Vertebral Artery Disease in Patients With Acutely Ruptured Intracranial Aneurysms |
| title_sort | role of ct angiography in detection of extracranial carotid and vertebral artery disease in patients with acutely ruptured intracranial aneurysms |
| topic | ct angiography aneurysm subarachnoid hemorrhage atherosclerosis of the brachiocephalic arteries brachiocephalic artery anomaly |
| url | https://www.innovmedkub.ru/jour/article/view/628 |
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