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Head and neck CT angiography to assess the internal carotid artery stealing pathway

Dongxu Wang1, Zheng Li1, Xiaoyang Zheng1

  • 1Departments of CT, The Second Affiliated Hospital of Qiqihar Medical College, 37 West Zhonghua Road, Qiqihar, Heilongjiang, 161006, PR China.

BMC Neurology
|September 5, 2020
PubMed

Insights

Common carotid artery occlusive disease can lead to internal carotid artery steal pathways. Computed tomography angiography (CTA) effectively identifies these pathways, aiding diagnosis and management.

Area of Science:

  • Vascular Surgery
  • Diagnostic Imaging
  • Neurology

Background:

  • Common carotid artery occlusive disease (CCAOD) can precipitate the formation of internal carotid artery (ICA) steal pathways.
  • Digital subtraction angiography (DSA) and computed tomography angiography (CTA) are key imaging modalities for diagnosing CCAOD and associated steal phenomena.

Purpose of the Study:

  • To investigate the utility of CTA in identifying internal carotid artery steal pathways in patients with CCAOD.
  • To analyze the characteristics and prevalence of ICA steal pathways in a cohort of CCAOD patients.

Main Methods:

  • Retrospective analysis of clinical and imaging data from 18 patients diagnosed with CCAOD.
  • Evaluation of ICA steal pathways using both DSA and CTA.

Main Results:

  • Internal carotid artery steal pathways were identified in 10 out of 18 patients with CCAOD.
  • Vascular ultrasound revealed absent CCA flow, retrograde ECA flow, and antegrade but decreased ICA flow on the affected side.
  • Six distinct ICA blood-stealing pathways were detailed, involving various collateral vessels such as the vertebral, occipital, and thyroid arteries.

Conclusions:

  • Computed tomography angiography (CTA) is a valuable tool for detecting internal carotid artery steal pathways in patients with common carotid artery occlusive disease.
  • Identifying these pathways is crucial for understanding disease progression and planning treatment strategies.
Abstract

Keywords:
Artery occlusiveCommon carotid arteryComputed tomography angiographyInternal carotid arterySteal bloodStroke

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