Pencil Beam Presaturation Magnetic Resonance Imaging Helps to Identify Patients at Risk for Intolerance to Temporary Internal Carotid Artery Occlusion During Carotid Endarterectomy and Carotid Artery Stenting

• Tanaka, Jun

• 細田, 弘吉

• Matsuo, Kazuya

• Kyotani, Katsusuke

• Takemoto, Youta

• Yamamoto, Yusuke

• 藤田, 敦史

• 甲田, 将章

• 木村, 英仁

• 篠山, 隆司

• 甲村, 英二

書誌事項

タイトル別名

• BeamSAT MRI helps to identify patients at risk for intolerance to temporary internal carotid artery occlusion during CEA and CAS

抄録

Background: There has been no effective method to predict ischemic intolerance to temporary internal carotid artery (ICA) occlusion during carotid artery reconstruction. Pencil beam presaturation (BeamSAT) pulse suppresses the flow signal of the target vessel in magnetic resonance angiography (MRA). Applying this method, we constructed ICA-selective MRA images. The aim of this study was to identify patients at risk for ischemic intolerance by ICA-selective MRA. Methods: By evaluating flow of anterior communicating artery (Acom) and A1 portion of anterior cerebral artery with ICA-selective MRA and posterior communicating artery (Pcom) with conventional MRA, we investigated associations of these collateral flow patterns with ischemic intolerance and decrease of regional cerebral oxygen saturation. Results: The study included 58 patients who underwent carotid endarterectomy or carotid artery stenting. Six of 7 patients without Acom flow and Pcom flow demonstrated ischemic intolerance, whereas all patients (n = 51) with Acom and/or Pcom flow demonstrated tolerance. The accuracy of this prediction model according to Acom and Pcom flow patterns for ischemic intolerance was 0.98 (P = 0.01, binomial test). Regional cerebral oxygen saturation decrease after ICA occlusion was significantly larger in patients without Acom flow and Pcom flow (12.0% ± 6.0%) than in patients with Acom flow and Pcom flow (3.0% ± 3.1%, P < 0.01) and in patients with Acom flow but no Pcom flow (2.4% ± 5.2%, P < 0.01). Conclusions: These findings support the importance of Acom flow as a collateral route. ICA-selective MRA enables prediction of ischemic intolerance to temporary ICA occlusion during carotid endarterectomy or carotid artery stenting. This method provides valuable information regarding probability of an ischemic complication.

収録刊行物

• World Neurosurgery

  World Neurosurgery 130 e899-e907, 2019-10

  Elsevier

キーワード

• BeamSAT
• CAS
• CEA
• ICA-selective MRA
• Intolerance

詳細情報

• CRID: 1050294045368596864
• NII論文ID: 120006993678
• NII書誌ID: AA12469471
• DOI: 10.1016/j.wneu.2019.07.033
• ISSN: 18788769
• ISSN: 18788750
• HANDLE: 20.500.14094/90007948
• Web Site: https://api.elsevier.com/content/article/PII:S1878875019319394?httpAccept=text/xml
• Web Site: https://api.elsevier.com/content/article/PII:S1878875019319394?httpAccept=text/plain
• 本文言語コード: en
• 資料種別: journal article
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