Why the study?
Does MRA accurately depict the carotid bifurcation compared to intra-operative DSA in patients in the early post-carotid endarterectomy period?
Does MRA accurately depict the carotid bifurcation compared to intra-operative DSA in patients in the early post-carotid endarterectomy period?
MRA is a potentially useful non-invasive tool for evaluating the carotid bifurcation early after endarterectomy, though it may overestimate stenosis.
MRA overestimation warrants caution in post-endarterectomy stenosis grading; case report leaves accuracy versus DSA open to prospective validation.
This preliminary study was designed to investigate the ability of multiple axial volume three-dimensional fourier transform (3DFT) time-of-flight (TOF) magnetic resonance angiography (MRA) to depict the carotid bifurcation in the early post-carotid endarterectomy period. Five patients underwent intra-operative digital subtraction angiography (DSA) and carotid MRA within 5 days of carotid endarterectomy. An axial volume fast imaging in steady-state precession (FISP) gradient-echo 3DFT TOF carotid MRA technique in this limited series appeared to display accurately the surgically significant abnormalities at the carotid bifurcation after endarterectomy. However, in normal or near-normal intra-operative DSA studies, overestimation of internal carotid artery stenoses was encountered. Postoperative MRA demonstrates potential as a useful non-invasive investigation after carotid endarterectomy but should be interpreted with caution until larger studies become available.
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Stuckey et al. (1995) studied this question.
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