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<meta name="DC.Title" content="Angiographic CT after Intravenous Contrast Agent Application: A Noninvasive Follow-Up Tool after Intracranial Angioplasty and Stenting" />
<meta name="DC.Identifier" content="10.3174/ajnr.A2168" />
<meta name="DC.Date" content="2010-11-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="Copyright © American Society of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: ICAS is one of the therapeutic options in symptomatic cerebral artery stenosis. iaDSA is the current criterion standard examination after ICAS for the detection of ISR. In this study, we evaluated ivACT as a potential noninvasive follow-up alternative.

MATERIALS AND METHODS: In 17 cases, ivACT and iaDSA were performed after ICAS. Both procedures were carried out on a flat-panel-detector-equipped angiography system. Postprocessing of ivACT acquisitions was performed on a dedicated workstation producing multiplanar reformations of the stent region and other intracranial arteries. Restenotic lesions were compared with iaDSA measurements. All studies were independently evaluated by 2 experienced neuroradiologists blinded to patients data.

RESULTS: In 5 cases, ISR was diagnosed on iaDSA images. All restenotic lesions were reliably detected (sensitivity, 100%; 95%CI, 48%–100%) and could be correctly quantified on ivACT images in comparison with iaDSA. The neuroradiologists correctly excluded ISR in 11 of 12 lesions after viewing the ivACT examinations (specificity, 92%; 95%CI, 62%–100%). Measurements of ISR on ivACT were highly correlated to iaDSA (Pearson r = 0.94, P &lt; .01).

CONCLUSIONS: IvACT is a promising noninvasive follow-up examination after ICAS. With its high spatial resolution, it can reliably detect or exclude ISR. Contrary to iaDSA, there is no need for a recovery period after ivACT and the risk of neurologic complications is practically lowered to zero.

A2
:   second segment of anterior cerebral artery
ACT
:   angiographic CT
BA
:   basilar artery
C3
:   third segment of ICA
CI
:   confidence interval
CTDIw
:   weighted CT dose index
ΔDSA%
:   change of stenosis percentage at follow-up iaDSA compared with measurements on iaDSA after stenting
DSApost
:   digital subtraction angiography after stenting
DSApre
:   digital subtraction angiography before stenting
DWI
:   diffusion-weighted imaging
IA
:   focal lesion involving the end of the stent
iaDSA
:   intra-arterial digital subtraction angiography
IB
:   focal lesion involving the body of the stent
IC
:   multiple restenotic foci involving &lt;50% of the stented segment
ICA
:   internal carotid artery
ICAS
:   intracranial artery angioplasty and stenting
II
:   diffuse intrastent lesion
ISR
:   in-stent restenosis
ivACT
:   ACT after intravenous contrast medium application
M1
:   first segment of middle cerebral artery
MDCTA
:   multidetector CT angiography
PTA
:   percutaneous transluminal angioplasty
rePTA
:   repeated PTA after ICAS
TIA
:   transient ischemic attack
V4
:   intracranial segment of vertebral artery" />
<meta name="DC.Contributor" content="M.-N. Psychogios" />
<meta name="DC.Contributor" content="P. Schramm" />
<meta name="DC.Contributor" content="J.-H. Buhk" />
<meta name="DC.Contributor" content="A. Xyda" />
<meta name="DC.Contributor" content="K. Gröschel" />
<meta name="DC.Contributor" content="K. Jung" />
<meta name="DC.Contributor" content="M. Knauth" />
<meta name="article:published_time" content="2010-11-01" />
<meta name="article:section" content="Brain" />
<meta name="citation_title" content="Angiographic CT after Intravenous Contrast Agent Application: A Noninvasive Follow-Up Tool after Intracranial Angioplasty and Stenting" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;ICAS is one of the therapeutic options in symptomatic cerebral artery stenosis. iaDSA is the current criterion standard examination after ICAS for the detection of ISR. In this study, we evaluated ivACT as a potential noninvasive follow-up alternative.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;In 17 cases, ivACT and iaDSA were performed after ICAS. Both procedures were carried out on a flat-panel-detector-equipped angiography system. Postprocessing of ivACT acquisitions was performed on a dedicated workstation producing multiplanar reformations of the stent region and other intracranial arteries. Restenotic lesions were compared with iaDSA measurements. All studies were independently evaluated by 2 experienced neuroradiologists blinded to patients data.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;In 5 cases, ISR was diagnosed on iaDSA images. All restenotic lesions were reliably detected (sensitivity, 100%; 95%CI, 48%–100%) and could be correctly quantified on ivACT images in comparison with iaDSA. The neuroradiologists correctly excluded ISR in 11 of 12 lesions after viewing the ivACT examinations (specificity, 92%; 95%CI, 62%–100%). Measurements of ISR on ivACT were highly correlated to iaDSA (Pearson &lt;i&gt;r&lt;/i&gt; = 0.94, &lt;i&gt;P&lt;/i&gt; &amp;lt; .01).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;IvACT is a promising noninvasive follow-up examination after ICAS. With its high spatial resolution, it can reliably detect or exclude ISR. Contrary to iaDSA, there is no need for a recovery period after ivACT and the risk of neurologic complications is practically lowered to zero.&lt;/p&gt;" />
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<meta name="twitter:title" content="Angiographic CT after Intravenous Contrast Agent Application: A Noninvasive Follow-Up Tool after Intracranial Angioplasty and Stenting" />
<meta name="twitter:card" content="summary_large_image" />
<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/31/10.cover.gif" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: ICAS is one of the therapeutic options in symptomatic cerebral artery stenosis. iaDSA is the current criterion standard examination after ICAS for the detection of ISR. In this study, we evaluated ivACT as a potential noninvasive follow-up alternative.

MATERIALS AND METHODS: In 17 cases, ivACT and iaDSA were performed after ICAS. Both procedures were carried out on a flat-panel-detector-equipped angiography system. Postprocessing of ivACT acquisitions was performed on a dedicated workstation producing multiplanar reformations of the stent region and other intracranial arteries. Restenotic lesions were compared with iaDSA measurements. All studies were independently evaluated by 2 experienced neuroradiologists blinded to patients data.

RESULTS: In 5 cases, ISR was diagnosed on iaDSA images. All restenotic lesions were reliably detected (sensitivity, 100%; 95%CI, 48%–100%) and could be correctly quantified on ivACT images in comparison with iaDSA. The neuroradiologists correctly excluded ISR in 11 of 12 lesions after viewing the ivACT examinations (specificity, 92%; 95%CI, 62%–100%). Measurements of ISR on ivACT were highly correlated to iaDSA (Pearson r = 0.94, P &lt; .01).

CONCLUSIONS: IvACT is a promising noninvasive follow-up examination after ICAS. With its high spatial resolution, it can reliably detect or exclude ISR. Contrary to iaDSA, there is no need for a recovery period after ivACT and the risk of neurologic complications is practically lowered to zero.

A2
:   second segment of anterior cerebral artery
ACT
:   angiographic CT
BA
:   basilar artery
C3
:   third segment of ICA
CI
:   confidence interval
CTDIw
:   weighted CT dose index
ΔDSA%
:   change of stenosis percentage at follow-up iaDSA compared with measurements on iaDSA after stenting
DSApost
:   digital subtraction angiography after stenting
DSApre
:   digital subtraction angiography before stenting
DWI
:   diffusion-weighted imaging
IA
:   focal lesion involving the end of the stent
iaDSA
:   intra-arterial digital subtraction angiography
IB
:   focal lesion involving the body of the stent
IC
:   multiple restenotic foci involving &lt;50% of the stented segment
ICA
:   internal carotid artery
ICAS
:   intracranial artery angioplasty and stenting
II
:   diffuse intrastent lesion
ISR
:   in-stent restenosis
ivACT
:   ACT after intravenous contrast medium application
M1
:   first segment of middle cerebral artery
MDCTA
:   multidetector CT angiography
PTA
:   percutaneous transluminal angioplasty
rePTA
:   repeated PTA after ICAS
TIA
:   transient ischemic attack
V4
:   intracranial segment of vertebral artery" />
<meta name="og-title" property="og:title" content="Angiographic CT after Intravenous Contrast Agent Application: A Noninvasive Follow-Up Tool after Intracranial Angioplasty and Stenting" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/31/10/1886" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: ICAS is one of the therapeutic options in symptomatic cerebral artery stenosis. iaDSA is the current criterion standard examination after ICAS for the detection of ISR. In this study, we evaluated ivACT as a potential noninvasive follow-up alternative.

MATERIALS AND METHODS: In 17 cases, ivACT and iaDSA were performed after ICAS. Both procedures were carried out on a flat-panel-detector-equipped angiography system. Postprocessing of ivACT acquisitions was performed on a dedicated workstation producing multiplanar reformations of the stent region and other intracranial arteries. Restenotic lesions were compared with iaDSA measurements. All studies were independently evaluated by 2 experienced neuroradiologists blinded to patients data.

RESULTS: In 5 cases, ISR was diagnosed on iaDSA images. All restenotic lesions were reliably detected (sensitivity, 100%; 95%CI, 48%–100%) and could be correctly quantified on ivACT images in comparison with iaDSA. The neuroradiologists correctly excluded ISR in 11 of 12 lesions after viewing the ivACT examinations (specificity, 92%; 95%CI, 62%–100%). Measurements of ISR on ivACT were highly correlated to iaDSA (Pearson r = 0.94, P &lt; .01).

CONCLUSIONS: IvACT is a promising noninvasive follow-up examination after ICAS. With its high spatial resolution, it can reliably detect or exclude ISR. Contrary to iaDSA, there is no need for a recovery period after ivACT and the risk of neurologic complications is practically lowered to zero.

A2
:   second segment of anterior cerebral artery
ACT
:   angiographic CT
BA
:   basilar artery
C3
:   third segment of ICA
CI
:   confidence interval
CTDIw
:   weighted CT dose index
ΔDSA%
:   change of stenosis percentage at follow-up iaDSA compared with measurements on iaDSA after stenting
DSApost
:   digital subtraction angiography after stenting
DSApre
:   digital subtraction angiography before stenting
DWI
:   diffusion-weighted imaging
IA
:   focal lesion involving the end of the stent
iaDSA
:   intra-arterial digital subtraction angiography
IB
:   focal lesion involving the body of the stent
IC
:   multiple restenotic foci involving &lt;50% of the stented segment
ICA
:   internal carotid artery
ICAS
:   intracranial artery angioplasty and stenting
II
:   diffuse intrastent lesion
ISR
:   in-stent restenosis
ivACT
:   ACT after intravenous contrast medium application
M1
:   first segment of middle cerebral artery
MDCTA
:   multidetector CT angiography
PTA
:   percutaneous transluminal angioplasty
rePTA
:   repeated PTA after ICAS
TIA
:   transient ischemic attack
V4
:   intracranial segment of vertebral artery" />
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<div id="hw-article-author-popups-top-node-9697--61896156729" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">M.-N. Psychogios </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.-N.%2BPsychogios%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Psychogios%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.-N.%2BPsychogios%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">P. 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Xyda </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BXyda%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Xyda%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.%2BXyda%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">K. 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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">M.-N.</span> <span class="nlm-surname">Psychogios</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Schramm</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">J.-H.</span> <span class="nlm-surname">Buhk</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Xyda</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Gröschel</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Jung</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Knauth</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 2010, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1886-1891; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2168 </span></div>
  
  
  
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