Objective Case 1 Case 2 ConclusionKey Words

C-arm CT allows CBV measurements immediately after CAS without requiring transport of the patient out of the angiography room, and it may enable the evaluation of hyperperfusion before and after CAS.

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Objective: CT-like images and cerebral blood volume (CBV) measurements have become available due to technical improvements in the angiographic C-arm system and workstation. In this study, we evaluated the usefulness of C-arm CBV measurements in patients with acute ischemic stroke. Methods:The study included 27 consecutive patients admitted for acute ischemic stroke due to major intracranial artery occlusion within 7 hours of onset. Cerebral angiography and C-arm CBV measurements were performed immediately after CT or MRI. The areas with reduced CBV in CBV color maps were classified into infarcted and non-infarcted areas according to CT/MRI images obtained 8-48 hours after onset, and their relationship with CBV was retrospectively evaluated. Results:The mean CBV values and the relative CBV ratios (ipsilateral/contralateral side) were 1.29 ± 0.51 mL/100 g and 0.41 ± 0.17 in the infarcted area and 3.19 ± 0.17 mL/100 g and 0.8 ± 0.1 in the non-infarcted areas. The CBV values and relative CBV ratios in infarcted areas with hemorrhage (n = 5) were 0.95 ± 0.56 mL/100 g and 0.3 ± 0.17, and significantly lower than in infarcted areas without hemorrhage.Conclusion: C-arm CBV measurements with an angiography system can be performed readily in a short time and may provide useful information for the treatment of acute ischemic stroke patients.

Objective: To evaluate changes related to cerebral endovascular treatment, a C-arm cerebral blood volume (CBV) study was performed before and after treatment. Although conditions related to treatment-administered contrast medium of the pretreatment examination differs from that for post-treatment, no study has investigated the effect on the results. In this study, we examined differences in the results of the C-arm CBV examination before and after treatment in patients who underwent carotid artery stenting (CAS). Subjects and Methods:Fifteen subjects were included in this study. The time interval until the volume of contrast medium reached a peak in points established at the proximal and distal sites of stenosis on a lateral view of a cervical common carotid artery angiogram before and after treatment was ≤0.5 seconds. For the C-arm CBV study, 25% diluted contrast medium was trans-arterially administered. The first C-arm CBV study was performed before angiography for preoperative assessment, and the second study was performed immediately after the completion of the CAS. The mean CBV value in each vascular territory was calculated, and the change in CBV after treatment was evaluated. In addition, the relative CBV ratio was calculated.Results: For both the unaffected and affected sides, the CBVs measured in the post-treatment study were high. When evaluating the relative CBV ratio, there were no marked changes after treatment. The value was constant. Conclusion:The results suggest that a C-arm CBV study is influenced by the contrast medium used during treatment.To apply a C-arm CBV study for pretreatment and post-treatment evaluation, relative evaluation parameters, such as the relative CBV ratio, should be used.Keywords▶ C-arm cerebral blood volume, relative cerebral blood volume value, contrast medium, carotid artery stenting