Time-Resolved 4-Dimensional Computed-Tomography Angiography Can Correctly Identify Carotid Pseudo-Occlusion

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Abstract

Correct identification of symptomatic high-grade internal carotid artery stenosis from low-grade or total chronic occlusion is critical for patient selection for urgent carotid endarterectomy. Carotid pseudo-occlusion is a flow-related artifact on noninvasive imaging that can lead to an incorrect diagnosis of total internal carotid artery occlusion, thereby denying an eligible patient for appropriate surgical treatment. We present an 82-year-old man with a symptomatic critical internal carotid artery, which was detected on time-resolved 4-dimensional computed-tomography angiography, whereas single-phase computed-tomography angiography, magnetic resonance angiography, and Doppler ultrasonography suggested apparent occlusion. To our understanding, the use of 4-dimensional computed-tomography angiography to identify carotid pseudo-occlusion has not been previously reported.

Original languageEnglish
Pages (from-to)1005-1006
Number of pages2
JournalJournal of Stroke and Cerebrovascular Diseases
Volume25
Issue number4
DOIs
Publication statusPublished - 1 Apr 2016

Keywords

  • 4D-CTA
  • carotid endarterectomy
  • Carotid pseudo-occlusion
  • carotid stenosis
  • transient ischemic attack

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