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Year : 2022  |  Volume : 70  |  Issue : 2  |  Page : 694--698

Clinical Study of High-Resolution C-Arm CT in Mechanical Recanalization and Stent Implantation for Chronic Cerebral Artery Occlusion

Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University; Interventional Institute of Zhengzhou University, Zhengzhou, China

Correspondence Address:
Dr. Jian-Zhuang Ren
No. 1 Jianshe East Road, Zhengzhou City
Dr. Xin-Wei Han
No. 1 Jianshe East Road, Zhengzhou City
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.344607

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Background: 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. Objective: To evaluate the utility of high-resolution C-arm CT (Dyna micro-CT) for stent placement in patients with chronic cerebral artery occlusion. Methods and Materials: 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. Results: 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. Conclusions: 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.


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