This poster is published under an
open license. Please read the
disclaimer for further details.
Type:
Educational Exhibit
Keywords:
Obstruction / Occlusion, Education and training, Arteriosclerosis, Imaging sequences, Diagnostic procedure, Contrast agent-intravenous, CT-Quantitative, CT-Angiography, CT, Vascular, Neuroradiology brain, Arteries / Aorta
Authors:
A. V. Vishnevskaia, E. Kondratyev, A. Sidorov, S. A. Buryakina, G. Karmazanovsky; Moscow/RU
DOI:
10.1594/ecr2015/C-2508
Findings and procedure details
Patients with diagnosed subclavian steal syndrome underwent 256-MDCT-angiography before planed endovascular treatment.
At first we qualifyed arch elongation and arch vessel configuration with aims of to recognize the type of aortic arch.
There are three types of aortic arches but some authors have also suggested a type IV.
I Type : the arch vessels arise next to each other from arch in the same horizontal plane (Fig.1).
II Type : the brahiocephalic vessels arise not far from each other (Fig.2).
The distance from the brachiocephalic trunk to the top of the arch is between 1 and 2 left CCA diameters.
III Type; the arch vessels arise far apart.
The distance from the brachiocephalic trunk to the top of the arch is > 2 left CCA diameters(Fig.3).
The most common anomaly of the aortic arch is the bovine variety,
which occurs in about 27% of the population: the brachiocephalic trunk and the left CCA have a common origin (Fig.4).
Less frequent variations include a common origin of left CCA and left subclavian artery (1%) or a left vertebral artery originating from the arch (0.5%).
After that we qualifyed standard defined characters of subclavian stenosis or occlusion: amount (nonsignificant <75% and significant >75%) and length (local and prolongate in precise number value) of atheromatous plaque narrowing subclavian arteries (Fig.5); atheromatous plaque type (atherosclerosis calcific plaque,
atherosclerosis soft plaque,
atherosclerosis fibrous plaque or mixed) and characteristics of plaque’s fibrous cap (Fig.6);
Then we measured associated atherosclerotic vascular disease using precisely the same characteristics,
especially in entrances and intracranial segment.
Patient with SSS and main cerebral ischemic symptoms might be underwent brain MDCT-perfusion but in most cases we could see relevant nonspecific abnormal changes caused by general chronic atherosclerotic vascular disease.