Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University; Interventional Institute of Zhengzhou University, Zhengzhou, China.
Neurol India. 2022 Mar-Apr;70(2):694-698. doi: 10.4103/0028-3886.344607.
In recent years, among patients with chronic cerebral artery occlusion, recanalization can be achieved by an endovascular operation. However, complications and restenosis rates remain high.
To evaluate the utility of high-resolution C-arm CT (Dyna micro-CT) for stent placement in patients with chronic cerebral artery occlusion.
We retrospectively reviewed the clinical data of 27 patients with chronic cerebral artery occlusion who underwent mechanical recanalization and stent implantation. Images were reconstructed using conventional C-arm CT (Dyna CT) and Dyna micro-CT. Whether the stent was fully expanded and image quality was evaluated. Follow-up assessments included clinical and angiographic outcomes and complications.
Twenty-two patients successfully underwent stenting (22 stents; 14 cases: Neuroform EZ; eight cases: Enterprise); stenting failed in five patients. Compared to Dyna CT, Dyna micro-CT afforded improved visualization of the stent structure, providing significantly improved image quality (P < 0.05). In seven patients, the stent under-expanded and dilatation was performed; thereafter, stent malapposition improved. One patient experienced sudden headache 22 hours after the procedure; CT showed intraparenchymal hemorrhage. The remaining 21 patients did not have acute thrombosis or bleeding complications and were followed up by imaging for 3-6 months. In three patients, digital subtraction angiography showed mild in-stent stenosis.
High-resolution C-arm CT can improve visualization of stent structures in chronic cerebral artery occlusion, making it easy to determine the extent of stent deployment and potentially reduce complications and stent restenosis.
近年来，慢性大脑中动脉闭塞患者可通过血管内手术实现再通，但并发症和再狭窄率仍居高不下。
评估高分辨率 C 臂 CT（Dyna micro-CT）在慢性大脑中动脉闭塞患者支架置入中的应用价值。
我们回顾性分析了 27 例接受机械再通和支架置入的慢性大脑中动脉闭塞患者的临床资料。使用常规 C 臂 CT（Dyna CT）和 Dyna micro-CT 对图像进行重建。评估支架是否完全扩张和图像质量。随访评估包括临床和血管造影结果及并发症。
22 例患者成功接受了支架置入术（22 枚支架；14 例：Neuroform EZ；8 例：Enterprise）；5 例患者支架置入失败。与 Dyna CT 相比，Dyna micro-CT 改善了支架结构的可视化效果，提供了显著改善的图像质量（P < 0.05）。在 7 例患者中，支架扩张不全，行扩张后支架贴壁不良得到改善。1 例患者在术后 22 小时突发头痛，CT 显示脑实质内出血。其余 21 例患者无急性血栓形成或出血并发症，并进行了 3-6 个月的影像学随访。在 3 例患者中，数字减影血管造影显示支架内轻度狭窄。
高分辨率 C 臂 CT 可改善慢性大脑中动脉闭塞患者支架结构的可视化效果，有助于确定支架扩张程度，从而可能降低并发症和支架再狭窄的风险。
