Current role of cerebral angiography in the diagnosis of cerebrovascular diseases.

Wolpert, Samuel M.; Caplan, L. R.

doi:10.2214/ajr.159.1.1609697

Cited by 49 publications

(19 citation statements)

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“…TOF MRA has been proven useful for visualizing occlusions or severe stenoses of major head and neck vessels [38]. In the present study, with as little as 20 min prolongation of the MR time, MRA identified and characterized vascular occlusions and stenoses well enough to obviate the need for catheter exams in 1 of 5 cases and to help direct the angiogram in the other 4.…”

Section: Discussionsupporting

confidence: 48%

Selected Indications for and Applications of Magnetic Resonance Angiography in Children

Maas¹,

Barkovich

Liu

et al. 1994

Pediatr Neurosurg

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The purpose of this study was to investigate the efficacy and practicality of magnetic resonance angiography (MRA) in evaluating pediatric cerebrovascular disorders. A retrospective evaluation was performed of MR angiograms in 20 pediatric patients with cerebrovascular pathology. When appropriate, comparisons were made with duplex ultrasonography or conventional catheter angiography. MRA accurately assessed the patency of carotid reanastomoses in 8 babies who had previously undergone extracorporeal membrane oxygenation (ECMO). In 6 patients with moyamoya syndrome, MRA accurately evaluated stenotic intracranial carotid and circle of Willis arteries and progressive enlargement of the superficial temporal and middle cerebral arteries after revascularization procedures, and thus obviated the need for sequential angiograms. Thrombi and emboli were identified in 4 of 5 patients with symptoms and imaging evidence of an acute stroke. Two-dimensional time-of-flight MR venograms, acquired in both axial and coronal planes, were useful for preoperative venous mapping in a patient with an occipital encephalocele and detecting venoocclusive disease. MRA provided diagnostically useful information in a spectrum of pediatric cerebrovascular disorders. It can be used as the initial vascular imaging modality for patients with imaging evidence of acute cerebrovascular event, to evaluate progression of chronic vasoocclusive disease, to evaluate vessel patency following intracranial revascularization surgery, and for visualization of the venous circulation.

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Section: Discussionsupporting

confidence: 48%

Selected Indications for and Applications of Magnetic Resonance Angiography in Children

Maas¹,

Barkovich

Liu

et al. 1994

Pediatr Neurosurg

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“…Iv tpa is the fastest way to initiate therapy in hyperacute ischaemic stroke, but its efficacy in patients with lvo is questionable: it is well documented that Iv tpa has limited efficacy in recanalising lvo [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] (see table 2) and recanalisation is a strong predictor of good outcome 7,9,10,11,[22][23][24]34 . the larger clot volume ening endovascular therapy 6 .…”

Section: Recanalisation and Clinical Outcomes With IV Tpamentioning

confidence: 99%

Endovascular Therapy in Hyperacute Ischaemic Stroke: History and Current Status

2013

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This is a literature review on to the use of endovascular therapy in hyperacute ischaemic stroke secondary to large vessel occlusion (LVO). The prognosis for LVO is generally poor and the efficacy of intravenous tissue plasminogen activator (IV TPA) in the treatment of this subtype of stroke is questionable. It is well documented that recanalisation is associated with improved outcomes but IV TPA has limited efficacy in LVO recanalisation and the complication rates are higher for IV TPA in this stroke subset. Improved recanalisation rates have been demonstrated with intra-arterial TPA and first and second generation mechanical techniques but the rate of favourable outcome has not overtly mirrored this improvement. Several controversial trials using these early techniques have recently been published but fail to reflect modern practice which centres on the use of stent-retriever technology. This has been proven to be superior to older techniques. Not only are recanalisation rates higher, but the speed of recanalisation is greater and clinical results are improved. Multiple observational studies demonstrate consistently high rates of LVO recanalisation; TICI 2b/3 in the order of 65–95% and, rates of favourable outcome (mRS 0–2) in the order of 55% (42.5–77%) in clinically moderate to severe stroke with complicating symptomatic haemorrhage in the order of 1.5–15%. A major factor determining outcome is time to treatment but success has been demonstrated using these devices with bridging therapy, after IV TPA failure or as a stand-alone treatment.

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“…The gold standard technique for evaluating arterial dissections is catheter digital subtraction angiography (DSA). The benefi ts of this technique include higher sensitivity for detecting small intimal fl aps, intraluminal thrombus, intracranial extension, and the presence of aneurysms or other vascular anomalies [32,33]. The major drawback, especially in the sCAD population, is the risk of vessel dissection, which may be higher if there is an underlying collagen abnormality, and this has greatly limited its use in diagnosing this disease.…”

Section: Diagnosismentioning

confidence: 99%

Cervical artery dissection

Aböu-Chebl

2009

Curr Treat Options Cardio Med

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Spontaneous and traumatic cervical artery dissection is a common cause of stroke in the young. It generally carries an excellent prognosis if treatment is initiated early. Antiplatelet therapy may be as effective as or safer than warfarin, although no randomized prospective studies have addressed the issue of optimal medical therapy. Rarely, endovascular therapy may be indicated for the treatment of ruptured aneurysms or to prevent recurrent ischemia.

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Current role of cerebral angiography in the diagnosis of cerebrovascular diseases.

Cited by 49 publications

References 0 publications

Selected Indications for and Applications of Magnetic Resonance Angiography in Children

Selected Indications for and Applications of Magnetic Resonance Angiography in Children

Endovascular Therapy in Hyperacute Ischaemic Stroke: History and Current Status

Cervical artery dissection

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