Marios Psychogios, Presenter: Nothing to Disclose

Peter Schramm MD, Abstract Co-Author: Nothing to Disclose

Jan-Hendrik Buhk MD, Abstract Co-Author: Nothing to Disclose

Argyro Xyda MD, Abstract Co-Author: Nothing to Disclose

Klaus Gröschel, Abstract Co-Author: Nothing to Disclose

Klaus Jung, Abstract Co-Author: Nothing to Disclose

Michael Knauth MD, PhD, Abstract Co-Author: Nothing to Disclose

Intracranial artery angioplasty and stenting (ICAS) is one of the therapeutic options in the case of symptomatic cerebral artery stenosis. Intraarterial digital subtraction angiography (iaDSA) is the current gold-standard examination after ICAS for the detection of in-stent restenosis (ISR). In this study we evaluated the angiographic computed tomography after intravenous contrast medium application (ivACT) as a potential noninvasive follow-up alternative.

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 to iaDSA measurements. All studies were independently evaluated by two experienced neuroradiologists blinded to patients’ data.

In five 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 to iaDSA. The neuroradiologists correctly excluded ISR in 11 out of 12 lesions after viewing the ivACT exams (specificity = 92%, 95%-CI: [62%, 100%]). Measurements of ISR on ivACT were highly correlated to iaDSA (Pearson’s r = 0.94, p < 0.01).

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 neurological complications is practically lowered to zero.

IvACT: a new, noninvasive follow-up tool after intracranial angioplasty and stenting.

Psychogios, M, Schramm, P, Buhk, J, Xyda, A, Gröschel, K, Jung, K, Knauth, M, Angiographic Computed Tomography after Intravenous Contrast Agent Application: A Noninvasive Follow-up Tool after Intracranial Angioplasty and Stenting.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9013481.html