Type:
Educational Exhibit
Keywords:
Outcomes, Haemodynamics / Flow dynamics, Education and training, Treatment effects, Ultrasound, MR, CT-Angiography, Vascular, Neuroradiology brain
Authors:
G. Guzgunov, D. V. Georgieva, D. R. Petkov, A. P. D. E. Krastev , P. Chupetlovski, D. M. Al-Amin, PhD; Sofia/BG
DOI:
10.26044/ecr2019/C-3442
Background
Direct transtemporal external-to-internal carotid artery bypass is technique used for treatment of patients with chronic occlusion of internal carotid artery which became symptomatic and also for aneurysms not suitable for endovascular treatment [1,2]. This method shows good results in treatment in these patients [3,4,5].
With the revival of this nearly extinct technique [6] radiologists are tasked with making a choice of the appropriate imaging technique for immediate assessment of the surgical results and long-term follow-up of the operated patients.
A number of imaging tools are available,
ranging from Transcranial Doppler (TCD) to Computed tomography angiography (CTA) to Time of flight MR angiography (TOF MRA) and phase contrast MR angiography (PCA) to Contrast-enhanced MR angiography (CE-MRA) and to Arterial spin labelling (ASL) MR perfusion and Dynamic susceptibility contrast (DSC) MR perfusion.
No guidelines on the topic are available at the moment.
In our institution from 2016 to 2019 eighteen patients underwent extracranial-intracranial bypass surgery. Follow up of these patients was made mainly with CTA and in last two years more often with DSC.
There is no evidence of severe complications with these patients.