Helical CT angiography in the preoperative evaluation of carotid artery stenosis

76Citations
Citations of this article
9Readers
Mendeley users who have this article in their library.

Abstract

Purpose: To determine the utility and accuracy of helical CT angiography (CTA) in the evaluation of carotid artery stenosis. Methods: A comparison of CTA and conventional arteriogram was performed in 53 patients undergoing evaluation for carotid artery stenosis. Ninety-six carotid systems were evaluable. CTA stenosis was determined by the percent of area reduction seen on axial images through the level of greatest narrowing. MIP images were used to identify the point of maximal stenosis and to visualize overall vascular anatomy. The percent diameter stenosis was measured on conventional arteriograms using strict North American Symptomatic Carotid Endarterectomy Trial (NASCET) and European Carotid Surgery Trial (ECST) criteria. Results: Significant correlation was found between CTA and arteriography (NASCET method R = 0.87, ECST method R = 0.87, p < 0.001). Using NASCET >60% as an indicator for disease, CTA had a sensitivity of 87%, specificity of 90%, accuracy of 89%, negative predictive value of 88%, and positive predictive value of 89%. CTA identified plaque characteristics such as ulcerations (8), occlusion (10), fatty plaques (22), calcifications (48), and fibrosis (2). CTA underestimated 2 cases of short segment stenoses because of volume averaging, but this discrepancy was detected by duplex scan. No complications or renal dysfunction occurred with CTA; 1 patient became symptomatic during arteriography, necessitating termination of the procedure. Conclusion: CTA is a safe, non-invasive technique that precisely measures carotid artery area reduction and highly correlates to conventional arteriography. With this new technology, the current standards for carotid artery imaging may need to be reevaluated, and the precise role for helical CTA more clearly defined.

Cite

CITATION STYLE

APA

Cinat, M., Lane, C. T., Pham, H., Lee, A., Wilson, S. E., Gordon, I., … Moneta, G. (1998). Helical CT angiography in the preoperative evaluation of carotid artery stenosis. Journal of Vascular Surgery, 28(2), 290–300. https://doi.org/10.1016/S0741-5214(98)70165-X

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free