PLANNING A RECONSTRUCTION METHOD FOR DOLICHOARTERIOPATHIES OF THE INTERNAL CAROTID ARTERY BASED ON MULTISPIRAL COMPUTED TOMOGRAPHY
Introduction: The choice of the method of reconstruction on the carotid arteries (CA) depends on the type of dolichoarteriopathies of the internal carotid artery (DICA) and is selected based on the data of visual research methods. Recent advances in multispiral computed tomography (MSCT) and imaging techniques using the Software enable 3D images to be reconstructed for more accurate analysis.
The purpose of this study is to optimize preoperative planning for DICA based on contrast-enhanced MSCT data.
Methods: The study included 167 patients with clinical signs of cerebrovascular insufficiency (CVD) and hemodynamically significant DICA, who underwent contrast-enhanced MSCT. MSCT with contrast was performed on a Philips Brilliance iCT tomograph, the thickness of the resulting sections was not more than 0.6 mm. Three-dimensional images of CT scans were obtained using RadiAnt DICOM Viewer 2020.2.3 software. Based on the 3D image of MSCT with contrast, before surgical treatment, we compiled a protocol for assessing the state of the deformed area of the ICA. All patients were operated on, 30 patients had a bilateral lesion. They were operated on from the collateral side, as they had a clinic on both sides.
Results: In 137 patients, unilateral DICA was identified, kinking prevailed - 64%, C- and S-shaped tortuosities were less common - 26%, and coiling - 10%; bilateral DICA was much less common than unilateral - in 30 patients. The location of the deformed segment of the ICA relative to the angle of the mandibular (at the level / above / below): at the level - 75 (38%); higher - 94 (48%); below - 28 (14%). In 69 out of 197 cases, the excess of the ICA after its conditional straightening was less than 2 cm, in other cases (162) it was more than 2 cm. Out of 197 reconstructions on the CA for DICA, 69 operations were performed by the 1st method, 105 by the 2nd method, 21 by the 3rd method, 2 by the 4th method.
Conclusions: MSCT with contrasting allows obtaining information about the level of location of the pathologically altered ICA area, the type of deformation, and also allows calculating the excess of the artery after conditional straightening. All these data make it possible to correctly choose the method of reconstruction on the CA in DICA.
Yerbol K. Dogalbayev 1-3, https://orcid.org/0000-0001-8239-563X
Alexander B. Fursov 1, https://orcid.org/0000-0002-6992-8646
Tokan A. Sultanaliev 2, https://orcid.org/0000-0003-1732-9489
Irlan N. Sagandykov 2, https://orcid.org/0000-0002-9597-198X
Serik S. Suleimenov 2, https://orcid.org/0000-0002-4103-4130
1 NCJSC «Astana medical university», Nur-Sultan, Republic of Kazakhstan;
2 National research oncology center, Center for vascular surgery, Nur-Sultan, Republic of Kazakhstan;
3 Corporate Foundation University Medical Center, Intervention radiology unit,
Nur-Sultan, Republic of Kazakhstan.
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Dogalbayev Ye.K., Fursov A.B., Sultanaliev T.A., Sagandykov I.N., Suleimenov S.S. Planning a reconstruction method for dolichoarteriopathies of the internal carotid artery based on multispiral computed tomography // Nauka i Zdravookhranenie [Science & Healthcare]. 2022, (Vol.24) 2, pp. 24-31. doi 10.34689/SH.2022.24.2.003Related publications:
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