Application of C-arm CBV Measurement for Evaluation before and Immediately after Neuroendovascular Treatment

Abstract

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

C-arm CT Perfusion Study Using Angiography System

“…3) However, in qualitative evaluation to mainly identify the area with abnormal brain tissue has been mainly reported. [4][5][6][7][8][9] In addition, improvement of the angiography system and data acquisition methods has recently been tried and experimental studies on C-arm CTP described in this study have been occasionally reported. 1-3,10,13-19) Figure 6 outlines the three approaches for cerebral perfusion imaging using contrast medium performed at our institution.…”

“…C-arm CBV is acquired at steady state of contrast medium flow in brain tissue. [4][5][6][7][8][9] Since acquired information is limited to CBV, this method is useful to detect cerebral infarction, as a region with reduced CBV reflecting cerebrovascular occlusion-induced blockage of blood flow. However, the information in a CBV image is insufficient to evaluate mismatch between the area perfused by the occluded vessel and the salvageable ischemic area.…”