Angiographic Morphometry of Internal Carotid Artery Circulation in Turkish Children
Yonca Ozkan Arat1, Anil Arat, Kubilay Aydin
1Baskent University, Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey.
Insights
Pediatric internal carotid circulation (ICC) arteries grow rapidly, reaching near-adult size within 48 months. This supports the use of current intracranial stents in children for neuroendovascular interventions.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Vascular Imaging
Background:
- Cerebrovascular morphology is crucial for planning pediatric neuroendovascular interventions.
- Limited angiographic normative data exists for the pediatric cerebral circulation.
- Angiograms are infrequently performed in children, except for specific conditions like arteriovenous malformations.
Purpose of the Study:
- To measure internal carotid circulation (ICC) artery diameters in pediatric patients using digital subtraction angiography.
- To determine the growth trends of ICC arteries in children.
- To inform the selection of neuroendovascular devices for pediatric use.
Main Methods:
- Retrospective cross-sectional study of 64 pediatric patients (4-122 months) with retinoblastoma.
- Measurements of internal carotid artery (ICA) segments (petrous, cavernous, supraclinoid, choroidal) and anterior cerebral artery (ACA) and middle cerebral artery (MCA) diameters.
- Analysis of diameter correlation with patient age.
Main Results:
- Significant age-related growth correlations were found for ICA and ACA diameters, with most growth occurring within the first 36-48 months.
- Middle cerebral artery (MCA) diameter showed no significant correlation with age, reaching 87% of adult size by 6 months.
- Internal carotid circulation (ICC) arteries achieved 81%-99% of adult diameters by 48 months, significantly more than iliac arteries (59%).
Conclusions:
- The rapid growth pattern of pediatric ICC arteries suggests current intracranial stents are likely tolerable.
- The existing range of intracranial stents and stent-like devices appears adequate for the pediatric population.
- This data provides valuable insights for neuroendovascular intervention planning in children.
Aim:
Knowledge of cerebrovascular morphology is integral in planning neuroendovascular interventions, especially for procedures involving placement of stents, flow diverters or stentrievers. There is insufficient data on angiographic normative values of cerebral circulation in the pediatric age group since angiograms are uncommonly performed in children except for arteriovenous malformations in which arterial dimensions are larger than normal. We aimed to measure the diameters of internal carotid circulation (ICC) arteries on digital subtraction angiograms of pediatric patients and determine the growth trends.
Material And Methods:
This is a retrospective cross-sectional study measurements of ICC arteries of 64 pediatric patients (4-122 months) with retinoblastoma undergoing intra-arterial chemotherapy.
Results:
Petrous, cavernous, supraclinoid and choroidal segments of internal carotid artery (ICA) and anterior cerebral artery (ACA) diameters had significant correlation with age. Most of the growth was noted in the first 36-48 months of life. Middle cerebral artery (MCA) diameter did not show significant correlation with age. 87% of the adult diameter of the MCA was attained in the first 6 months of life. ICC arteries reached 81% to 99% of adult sizes in the first 48 months of life. On the contrary, the main iliac artery was only 59% of the adult diameter at this age group.
Conclusion:
Use of current intracranial stents in children appears tolerable due to the growth pattern of ICC arteries. Based on this data, the current armamentarium of intracranial stents or stent-like devices is sufficient to cover the need in the pediatric population.
