Fehlermöglichkeiten bei Gefäßpatienten durch Normvarianten der A. pharyngea ascendens

Pohlmann, C.; Brüning, R.; Höltje, J.; Arning, Christian

doi:10.1007/s00115-016-0166-1

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…Misdiagnosis of internal carotid artery dissection may occur if the ascending pharyngeal artery arises from the internal carotid artery and runs longitudinally alongside it (▶ Fig. 19) [18]. As described above for arterial fenestration, a pathological flow pulse curve would be expected in at least one lumen during a dissection.…”

Section: Outflow Anomaly Of the Ascending Pharyngeal Arterymentioning

confidence: 99%

“…Wenn die Arteria pharyngea ascendens aus der Arteria carotis interna abgeht und in Längsrichtung neben dieser verläuft (▶ Abb. 19), kann die Fehldiagnose einer Dissektion der Arteria carotis interna entstehen [18]. Wie oben bei der Arterienfensterung beschrieben, wäre bei einer Dissektion eine pathologische Strompulskurve in wenigstens einem Lumen zu er-…”

Section: Abgangsanomalie Der Arteria Pharyngea Ascendensunclassified

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Ultrasound Criteria for Diagnosing Spontaneous Cervical Artery Dissections

Arning

2023

Ultraschall Med

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Spontaneous dissection of brain-supplying cervical arteries, which also includes findings after minor injuries, is one of the main causes of ischaemic strokes in young adults. Strokes due to dissection are usually due to arterio-arterial embolism. They are rarely the first symptom of dissection because an intraluminal thrombus must first develop. Therefore, early diagnosis of dissection can contribute to stroke prevention – through immediate therapy with anticoagulants or antiplatelet drugs. This article describes the diagnostic criteria and typical findings of spontaneous dissection, in which no dissecting membrane is to be expected as in aortic dissection. Traumatic dissections following blunt or penetrating injuries also present with different findings. Examiners should be aware of possible differential diagnoses whose ultrasound image may mimic a dissection. A frequently occurring but avoidable cause of misdiagnosis is idiopathic carotidynia. Ultrasound also enables differentiation between dissection and vasculitis or carotid web and detection of normal variants such as fenestration of the vertebral artery. Further possibilities for misdiagnosis may arise in the presence of a variant of the ascending pharyngeal artery or in extracranial vasospasm. The different imaging techniques for the detection of a dissection are complementary, as false-negative findings occur with all techniques; no method serves as the gold standard. In any case, ultrasound can make an important contribution to the detection of a dissection, and it is worth knowing the diagnostic criteria.

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Section: Outflow Anomaly Of the Ascending Pharyngeal Arterymentioning

confidence: 99%

Section: Abgangsanomalie Der Arteria Pharyngea Ascendensunclassified

Ultrasound Criteria for Diagnosing Spontaneous Cervical Artery Dissections

Arning

2023

Ultraschall Med

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“…PITFALLS ( [30,33,33] KEY TAKEAWAYS ▪ All findings should be understandable based on the image and curve documentation ▪ The multiparametric approach to ICA stenosis grading is based on both peak systolic and diastolic flow velocities and B-scan morphologic criteria; in high-grade stenoses, it is additionally based on indirect criteria and the presence of collateral circulation. ▪ A multiparametric approach enables grading of high-grade ICA stenosis in 10 % increments ▪ Intima-media thickness (IMT) is determined in a plaque-free region 2 cm proximal to the bulb in the CCA on the posterior vessel wall ▪ In B-mode imaging, atherosclerotic plaques are described using echogenicity, internal structure, and surface ▪ The origin of the vertebral artery from the subclavian artery is a predisposition site for stenosis ▪ Criteria for stenosis of the vertebral artery at the origin from the subclavian artery is an anglecorrected PSV > 120 cm/s ▪ There is hypoplasia of the VA with an absolute lumen diameter ≤ 2.0-2.5 mm in several segments or a diameter ratio compared to the opposite side > 1:1.7 ▪ Higher-grade stenosis of the subclavian artery leads to a subclavian steal syndrom of the ipsilateral vertebral artery ▪ Criteria of a subclavian steal syndrome of the VA include systolic deceleration (grade 1) of the flow profile, alternating flow (grade 2), or completely retrograde flow (grade 3) in the VA…”

Section: Stents In the Internal Carotid Arterymentioning

confidence: 99%

Ultrasound assessment of brain supplying arteries (extracranial)

Gröschel,

Harrer,

Schminke

et al. 2023

Ultraschall Med

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Ultrasonography of the brain-supplying arteries is a non-invasive and highly efficient technique for the assessment of a stenosis or a vessel occlusion in patients with cerebrovascular diseases. This article reviews the examination technique for a standardized ultrasound assessment of the extracranial carotid and vertebral arteries. It further describes the multiparametric grading criteria of internal carotid artery stenosis and it gives recommendations for a standardised documentation of findings. Additionally, it proposes recommendations for intima-media thickness measurement and for classifying atherosclerotic plaques with B-mode ultrasonography. Moreover, criteria for the diagnosis of in-stent stenoses, vertebral artery dissections and subclavian steal syndrome are provided.

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