Keywords:
Arteries / Aorta, Vascular, CT-Angiography, MR, Image manipulation / Reconstruction, Segmentation, Surgery, Arteriosclerosis, Ischaemia / Infarction
Authors:
A. Panajotu, Z. Mihály, B. Szilveszter, F. I. Suhai, L. Entz, P. Sótonyi, P. Maurovich-Horvat; Budapest/HU
DOI:
10.26044/ecr2019/C-2495
Aims and objectives
The reconstruction of internal carotid artery (ICA) stenosis is an effective method to reduce stroke risk.
The indication for surgery is the presence of a significant grade ICA diameter stenosis (above 70%).
According to the international literature in association with surgery the perioperative stroke risk is under 3-2%,
whereas the stroke risk in case of significant stenosis is 0.7-1.1%/year in asymptomatic and 20-25%/5 years in symptomatic patients (Halliday et al.
2010; Rothwell et al.
2004).
Latest ESVS guideline recommends intervention for asymtomatic patients with higher stroke risk,
although there is currently no widely accepted imaging technique available to predict the so called potentially higher stroke risk population in clinical practice (Naylor et al.
2017).
To better understand the risk of ICA stenosis the aims of our study were:
1,
The identification of plaque components with software analysis on preoperativ carotid CTA images of patients with significant internal carotid artery stenosis.
2,
The prediction of risk for cerebral ischemia caused by plaque instability,
based on the connection between the volume of plaque components and the increasing number of ischemic lesions in relevant side carotid artery related cerebral regions on MRI images.