Angiographic CT after intravenous contrast agent application: A noninvasive follow-up tool after intracranial angioplasty and stenting.
OBJECTIVE
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.


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.
Psychogios
M-N
MN
Department of Neuroradiology, University Medicine Goettingen, Germany. m.psychogios@med.uni-goettingen.de
Schramm
P
P
Buhk
J-H
JH
Xyda
A
A
Gröschel
K
K
Jung
K
K
Knauth
M
M
D000368:Aged; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography / Q000379:methods*; D002548:Cerebral Revascularization; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000473:pathology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media