BACKGROUND AND PURPOSE: ICAS is one of the therapeutic options in symptomatic cerebral artery stenosis. iaDSA is the current criterion standard examination after ICAS for the detection of ISR. In this study, we evaluated ivACT as a potential noninvasive follow-up alternative. MATERIALS AND METHODS: In 17 cases, ivACT and iaDSA were performed after ICAS. Both procedures were carried out on a flat-panel-detector-equipped angiography system. Postprocessing of ivACT acquisitions was performed on a dedicated workstation producing multiplanar reformations of the stent region and other intracranial arteries. Restenotic lesions were compared with iaDSA measurements. All studies were independently evaluated by 2 experienced neuroradiologists blinded to patients data. RESULTS: In 5 cases, ISR was diagnosed on iaDSA images. All restenotic lesions were reliably detected (sensitivity, 100%; 95%CI, 48%–100%) and could be correctly quantified on ivACT images in comparison with iaDSA. The neuroradiologists correctly excluded ISR in 11 of 12 lesions after viewing the ivACT examinations (specificity, 92%; 95%CI, 62%–100%). Measurements of ISR on ivACT were highly correlated to iaDSA (Pearson r = 0.94, P < .01). CONCLUSIONS: IvACT is a promising noninvasive follow-up examination after ICAS. With its high spatial resolution, it can reliably detect or exclude ISR. Contrary to iaDSA, there is no need for a recovery period after ivACT and the risk of neurologic complications is practically lowered to zero. Abbreviations A2 second segment of anterior cerebral artery ACT angiographic CT BA basilar artery C3 third segment of ICA CI confidence interval CTDI w weighted CT dose index ΔDSA% change of stenosis percentage at follow-up iaDSA compared with measurements on iaDSA after stenting DSA post digital subtraction angiography after stenting DSA pre digital subtraction angiography before stenting DWI diffusion-weighted imaging IA focal lesion involving the end of the stent iaDSA intra-arterial digital subtraction angiography IB focal lesion involving the body of the stent IC multiple restenotic foci involving <50% of the stented segment ICA internal carotid artery ICAS intracranial artery angioplasty and stenting II diffuse intrastent lesion ISR in-stent restenosis ivACT ACT after intravenous contrast medium application M1 first segment of middle cerebral artery MDCTA multidetector CT angiography PTA percutaneous transluminal angioplasty rePTA repeated PTA after ICAS TIA transient ischemic attack V4 intracranial segment of vertebral artery
American Journal of Neuroradiology – American Journal of Neuroradiology
Published: Nov 1, 2010
It’s your single place to instantly
discover and read the research
that matters to you.
Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.
All for just $49/month
Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly
Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.
Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.
Read from thousands of the leading scholarly journals from SpringerNature, Wiley-Blackwell, Oxford University Press and more.
All the latest content is available, no embargo periods.
“Hi guys, I cannot tell you how much I love this resource. Incredible. I really believe you've hit the nail on the head with this site in regards to solving the research-purchase issue.”Daniel C.
“Whoa! It’s like Spotify but for academic articles.”@Phil_Robichaud
“I must say, @deepdyve is a fabulous solution to the independent researcher's problem of #access to #information.”@deepthiw
“My last article couldn't be possible without the platform @deepdyve that makes journal papers cheaper.”@JoseServera