COMPUTED ANGIOGRAPHY IN DEDICATED ASSESSMENT OF OCCLUSIVE CAROTID DISEASE FOR RECONSTRUCTIVE SURGERY PLANNING

Objective – to optimize dedicated assessment of carotid arteries in case of occlusive disease with computed angiography (CTA).

Material and methods. During 2015–2016 years 65 patients underwent ultrasound examination and computed tomography examined before carotid surgery.

Results. Aortic arc branching variants were observed in 26% cases. In 51% combined steno-occlusive process in common, internal carotid arteries and subclavian arteries was confirmed. In 29% of cases atherosclerotic plagues were detected in upper parts of common carotid arteries and such data changed surgical strategy. Patients included in study has internal carotid artery (ICA) stenosis more than 50% NASCET. Detailed assessment was used for cervical ICA distal to stenosis. In 62% of patients with carotid subocclusion narrowing in upper segments were detected. In 3 cases ascending pharyngeal artery arose from affected carotid artery and these findings change surgical approach. All patients underwent carotid surgery. Degree of ICA stenosis detected with CTA was conformed. CTA data for carotid plague extension were less informative – intraoperative plague length exceeded CTA results.

Conclusion. CTA is high informative study that allows detailed assessment of occlusive carotid disease for carotid surgery. 

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