Abstract Archives of the RSNA, 2003


Non-invasive Assessment of Extra-Intracranial Bypass Grafts Using Helical Computed Tomography Angiography

Scientific Papers

Presented on December 4, 2003
Presented as part of Q11: Neuroradiology/Head and Neck (Stroke Detection II)


Eva Bueltmann MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: Extra-intracranial (EC/IC) arterial bypass surgery is an important adjunct in the treatment of chronic cerebral ischemia, in the management of complex cerebral aneurysms and skull base tumours. The assessment of bypass patency in the early postoperative period is mandatory for patient management. So far, this requires digital subtraction angiographic studies (DSA), which carry a 1% risk of neurological complications. The ability of helical CT-angiography (CTA) to assess bypass patency, as less invasive imaging modality was investigated in the present study Methods and Materials: Fourteen patients (9 male; 5 female; age (mean+/-sd) 46+/-12 yrs.) with symptomatic steno-occlusive cerebrovascular disease and hemodynamic compromise underwent standard EC/IC bypass procedure ("low-flow" bypass - A. temporalis superficialis - A. cerebri media anastomosis) via a temporal osteoclastic craniotomy. Bypass patency was studied with CTA between day 1 and 9 (mean: 3+/-2 days) and DSA between day 3 and 14 (mean: 7+/- 4 days) after surgery. Bypass patency in CTA was evaluated using overlapping 1.25mm source images and 3D-volume rendering analysis Results: DSA showed a patent bypass in 13/14 (93 %) studies. CTA demonstrated a sufficient EC/IC anastomosis in 12/14 (86 %) investigations. The sensitivity and specificity of CTA in comparison to DSA were 92% and 100%, respectively. No procedure related complication was observed. Conclusion: Our preliminary results suggest, that helical CTA permits the non-invasive assessment of EC/IC bypass patency in the early postoperative course.       Questions about this event email: eva.bueltmann@rad.ma.uni-heidelberg.de

Cite This Abstract

Bueltmann MD, E, Horn MD, P, Noelte, I, Vajkoczy, P, Schmiedek MD, P, Groden MD, C, Non-invasive Assessment of Extra-Intracranial Bypass Grafts Using Helical Computed Tomography Angiography.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3107130.html