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Comparing different MR angiography strategies of carotid stents in a vascular flow model: toward stent-specific recommendations in MR follow-up.

Summary of "Comparing different MR angiography strategies of carotid stents in a vascular flow model: toward stent-specific recommendations in MR follow-up."


INTRODUCTION:
Carotid artery stenting (CAS) requires adequate follow-up imaging to assess complications such as in-stent stenosis or occlusion. Options include digital subtraction angiography, CT angiography, ultrasound, and MR angiography (MRA), which may offer a non-invasive option for CAS follow-up imaging. The aim of this study was to assess contrast-enhanced MRA (CE-MRA) and three-dimensional time-of-flight MRA (3D-TOF) for visualization of the in-stent lumen in different carotid stents.
METHODS:
In this study, we compared CE-MRA and 3D-TOF of five different carotid stents (Guidant Acculink(R), Cordis Precise(R), Boston Wallstent(R), Abbot Vascular Xact(R), Cook Zilver(R)) in three diameters (4, 6, and 8 mm) using a vascular flow model at 3.0 T with the help of a recently developed carotid surface coil. Stent-related artifacts were objectively assessed by calculating artificial lumen narrowing (ALN) and relative in-stent signal (RIS).
RESULTS:
RIS and ALN depended heavily on stent type, stent diameter, and the employed MR sequence. ALN and RIS were relatively favorable for Acculink(R), Precise(R), and Zilver(R) stents with both CE-MRA and 3D-TOF. CE-MRA provided better results for the Wallstent, while the Xact stent was difficult to visualize with both MRA protocols.
CONCLUSION:
Both CE-MRA and 3D-TOF are viable options for depicting the in-stent lumen in carotid stents. For specific stents, 3D-TOF provided image quality comparable to CE-MRA and may thus be suitable for in vivo assessment. Development of stent-specific pathways for follow-up imaging seems advisable to address stent-related differences in image quality.

Affiliation

Department of Neuroradiology, University of Göttingen Medical School, Robert-Koch-Str. 40, 37075, Göttingen, Germany, a.froelich@gmail.com.

Journal Details

This article was published in the following journal.

Name: Neuroradiology
ISSN: 1432-1920
Pages:

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Medical and Biotech [MESH] Definitions

Non-invasive method of vascular imaging and determination of internal anatomy without injection of contrast media or radiation exposure. The technique is used especially in CEREBRAL ANGIOGRAPHY as well as for studies of other vascular structures.

Stents that are covered with materials that are embedded with chemicals that are gradually released into the surrounding milieu.

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Pathological conditions involving the CAROTID ARTERIES, including the common, internal, and external carotid arteries. ATHEROSCLEROSIS and TRAUMA are relatively frequent causes of carotid artery pathology.

The force that opposes the flow of BLOOD through a vascular bed. It is equal to the difference in BLOOD PRESSURE across the vascular bed divided by the CARDIAC OUTPUT.

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