Head and neck CT angiography to assess the internal carotid artery stealing pathway
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RESEARCH ARTICLE
Open Access
Head and neck CT angiography to assess the internal carotid artery stealing pathway Dongxu Wang1 , Zheng Li1, Xiaoyang Zheng1, Houyi Cong1, Tianyu Zhang1, Zhenghua Wang2, Yuguang Wang1* and Jun He3
Abstract Background: Common carotid artery occlusive disease (CCAOD) could form internal carotid artery steal pathways. Based on the diagnostic results of digital subtraction angiography (DSA), head and neck computed tomography angiography (CTA) was used to find the internal carotid artery stealing pathway after CCAOD. Methods: The clinical and imaging data of 18 patients with CCAOD were retrospectively analyzed. DSA and CTA was used to evaluate internal carotid artery steal pathways. Results: Of the 18 patients with CCAOD, 10 patients found internal carotid artery steal pathways. There were 7 males and 3 females. Vascular ultrasound examination of all patients: The affected side had no blood flow in common carotid artery (CCA), and had retrograde blood flow in the external carotid artery (ECA). The blood flow of the affected side was decreased in the internal carotid artery (ICA), but it was antegrade. DSA diagnosed 10 cases of CCA occlusion and CTA diagnosed 10 cases of CCA occlusion. DSA and CTA found 6 internal carotid artery blood stealing pathways: ① Vertebral artery → occipital artery → external carotid artery → internal carotid artery (6 cases); ② Thyrocervical trunk → ascending cervical artery → occipital artery → external carotid artery → internal carotid artery (7 cases); ③ Costocervical trunk → deep cervical artery → occipital artery → external carotid artery → internal carotid artery (6 cases); ④ Affected side thyroid neck trunk → inferior thyroid artery → superior thyroid artery → external carotid artery → internal carotid artery (2 cases); ⑤ Contralateral external carotid artery → contralateral superior thyroid artery → affected superior thyroid artery → external carotid artery → neck Internal artery (2 cases); ⑥ Parathyroid neck → superficial cervical artery → occipital artery → external carotid artery → internal carotid artery (1 case). Conclusions: The patients with CCAOD can find the internal carotid artery blood stealing pathway through CTA. Keywords: Computed tomography angiography, Stroke, Common carotid artery, Artery occlusive, Internal carotid artery, Steal blood
Background Common carotid artery occlusive disease (CCAOD) refers to severe stenosis (stenosis ≥80%), sub occlusion (stenosis ≥95%) and occlusion caused by various causes, which can cause ischemic stroke [1]. Cerebral blood flow compensation is more complicated with CCAOD. When * Correspondence: [email protected] 1 Departments of CT, The Second Affiliated Hospital of Qiqihar Medical College, 37 West Zhonghua Road, Qiqihar, Heilongjiang 161006, PR China Full list of author information is available at the end of the article
CCAOD occurs and the internal and external carotid arteries are unobstructed, the internal carotid artery pressure at the distal end of the lesion is significantly lower than t
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