Absence of the Anterior Communicating Artery on Selective MRA is Associated with New Ischemic Lesions on MRI after Carotid Revascularization

Yamashita, Shunsuke; Kohta, Masaaki; Hosoda, Kohkichi; Tanaka, Jun; Matsuo, Kazuya; Kimura, Hidehito; Tanaka, Kazuhiro; Fujita, Atsushi; Sasayama, Takashi

doi:10.3174/ajnr.a7570

Cited by 5 publications

(4 citation statements)

References 32 publications

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“…Different other studies, documented by Kardile (2013) found the absence of the AComA in 0.14 to 8.0% of cases 8. An AComA flow was not detected in 22/83 patients, thus in 36% of cases 9. To our knowledge, a high interhemispheric AComA, thus a false absence of that artery from its common location, was not reported previously.…”

Section: Discussioncontrasting

confidence: 46%

False Absence of the Anterior Communicating Artery and a Median Artery of Corpus Callosum

Rusu¹,

Lazăr²,

Toader

2023

Journal of Craniofacial Surgery

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The anterior communicating artery (AComA) normally joins the anterior cerebral arteries (ACAs) when they change their directions from horizontal to vertical. Each postcommunicating segment of the ACAs commonly sends off the callosomarginal artery (CMA) and continues as the pericallosal artery. While documenting the archived computed tomography angiogram of a 61-year-old male patient, a rare anatomic variant was found to be associated with a previously unreported one. Both ACAs had symmetrical horizontal and vertical segments, but the AComA was absent from the usual location. The right ACA continued as CMA without sending off a pericallosal artery. A median artery of corpus callosum (MACC) left from the horizontal segment of the left ACA. Then the left ACA continued as CMA. At 1.9 cm from its origin, the MACC was united to the right CMA by a high, interhemispheric AComA. Therefore, an AComA should be regarded as absent only after documenting the bilateral anastomoses within the interhemispheric fissure. A third interhemispheric main artery, such as a rarely occurring MACC, could be accurately documented by computed tomography angiogram to avoid unpleasant intraoperative hemorrhage or to establish a personalized endovascular route to the anterior cerebral system.

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Section: Discussioncontrasting

confidence: 46%

False Absence of the Anterior Communicating Artery and a Median Artery of Corpus Callosum

Rusu¹,

Lazăr²,

Toader

2023

Journal of Craniofacial Surgery

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“…Previous research has reported that the presence of collateral flow is a prerequisite for the impaired CVR caused by carotid artery stenosis. 9,10 In our earlier study on BeamSAT MRI, 6,7 we observed discrepancies in the time-of-flight (TOF) signal intensity of the MCA between conventional and ICA-selective MRA in certain cases. Additionally, contralateral ICA-selective MRA and VA-selective MRA showed cross flow or collateral flow to the MCA on the stenotic side in some cases.…”

Section: Introductionmentioning

confidence: 96%

“…Considering these issues, we explored the feasibility of assessing impaired CVR using pencil beam presaturation (BeamSAT) magnetic resonance imaging (MRI) technology, which does not require contrast agents or radioactive tracers. 6,7 BeamSAT MRI is a novel imaging method that uniquely enables the production of selective MRA images of specific arteries, such as the unilateral internal carotid artery (ICA) or vertebral artery (VA). 6,8 Accordingly, BeamSAT MRI is considered a minimally invasive method that provides an accurate evaluation of intracranial blood flow.…”

Section: Introductionmentioning

confidence: 99%

Predicting Impaired Cerebrovascular Reactivity and Hyperperfusion Syndrome with BeamSAT MRI in Carotid Artery Stenosis

Ikeuchi,

Kohta,

Yamashita

et al. 2024

Preprint

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BackgroundWe evaluated the impact of collateral flow of the middle cerebral artery (MCA) territory and cross flow visualized with internal carotid artery (ICA)-selective Magnetic resonance angiography (MRA) constructed by pencil beam presaturation (BeamSAT) pulse on preoperative cerebral hemodynamic status and postoperative hyperperfusion syndrome.MethodsFourty-eight patients who underwent carotid artery stenting or carotid endarterectomy were included. The preoperative status of collateral flow in the MCA territory and crossflow was assessed using ICA-selective MRA. Cerebral blood flow and cerebrovascular reactivity (CVR) were assessed using single-photon emission computed tomography. Potential signs of hyperperfusion syndrome (HPS) were retrospectively assessed by reviewing medical charts.ResultsPatients who either demonstrated mismatch in MCA signal intensity (MCA-MRA grade) between ICA-selective MRA by BeamSAT magnetic resonance imaging (MRI) and conventional MRA or whose MRA crossflow was visualized on BeamSAT MRI were placed in the developed collateral (DC) group (n=19). All other patients were placed in the undeveloped collateral (UC) group (n = 29). Preoperative ipsilateral CVR was significantly lower in the DC group than in the UC group (18.0±20.0% versus 48.3±19.5%; P<0.0001). Multivariate logistic regression analysis revealed that the DC group was significantly associated with impaired CVR (odds ratio [OR] = 17.7, [95%confidence interval [CI]: 1.82 to 171]; P = 0.013). The partial area under curves (AUCs) of BeamSAT logisitic model (0.843) were significantly larger than those of the conventional logistic model (0.626) over the range of high sensitivity (0.6-1) (p = 0.04). The incidence of postoperative symptoms suggestive of HPS was significantly higher in the DC group than in the UC group (8/19 vs. 1/29; P=0.001).ConclusionsThe differences in the MCA-MRA grade and crossflow between ICA-selective and conventional MRA were associated with impaired CVR. BeamSAT MRI may be a valuable and non-invasive tool for assessing of cerebral hemodynamics and predicting postoperative HPS.

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“…Currently, the assessment of skin autografts revascularization is mainly depended on the surgeons' experience, such as color, temperature or postoperative time, however, these signs are subjective and have limited sensitivity and/or specificity [12]. In addition, the diameters of revascularization in skin autografts are too small to monitoring of skin autografts revascularization via routine imaging modalities including ultrasound, x-ray, CTA, MRA [13][14][15]. Actually, these imaging techniques are still disappointing to show the skin autografts revascularization.…”

Section: Introductionmentioning

confidence: 99%

Monitoring angiogenesis in skin autografts using photoacoustic microscopy

Zhang,

Liu,

Yuan

et al. 2023

Journal of Biophotonics

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Abstract(1)Background: Skin autografts have been broadly used to manage the skin and soft tissue defects. It's important for surgeons to assess the vitality of skin autografts via observing the angiogenesis. However, there is lack of reliable approach for giving the quantitative angiogenesis information on the skin autografts. Recently, photoacoustic microscopy imaging has attracted much attention based on its good performance in angiography; (2) Methods: In this study, we aim to monitor angiogenesis in skin autografts via PAM, and further verify its clinical potential for the early prediction of skin autografts clinical outcome; (3) Results and Conclusions: The results indicate that PAM is a feasible, precise, high‐resolution, non‐invasive technique for the early prediction of necrosis of skin autografts via monitoring the angiogenesis, providing a promising tool for surgeons to use this surgical technology.This article is protected by copyright. All rights reserved.

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Absence of the Anterior Communicating Artery on Selective MRA is Associated with New Ischemic Lesions on MRI after Carotid Revascularization

Cited by 5 publications

References 32 publications

False Absence of the Anterior Communicating Artery and a Median Artery of Corpus Callosum

False Absence of the Anterior Communicating Artery and a Median Artery of Corpus Callosum

Predicting Impaired Cerebrovascular Reactivity and Hyperperfusion Syndrome with BeamSAT MRI in Carotid Artery Stenosis

Monitoring angiogenesis in skin autografts using photoacoustic microscopy

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