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Research ArticleExtracranial Vascular
Open Access

Symptomatic and Asymptomatic Chronic Carotid Artery Occlusion on High-Resolution MR Vessel Wall Imaging

M. Wan, L. Yan, Z. Xu, Z. Hou, K. Kang, R. Cui, Y. Yu, J. Song, F.K. Hui, Y. Wang, Z. Miao, X. Lou and N. Ma
American Journal of Neuroradiology January 2022, 43 (1) 110-116; DOI: https://doi.org/10.3174/ajnr.A7365
M. Wan
aFrom the Department of Interventional Neuroradiology (M.W., L.Y., Z.H., R.C., Y.Y., J.S., Z.M., N.M.)
cChina National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China
fDepartment of Neurology (M.W.), Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing, China
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L. Yan
aFrom the Department of Interventional Neuroradiology (M.W., L.Y., Z.H., R.C., Y.Y., J.S., Z.M., N.M.)
cChina National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China
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Z. Xu
dDepartment of Neurology (Z.X.), The First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou, China
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Z. Hou
aFrom the Department of Interventional Neuroradiology (M.W., L.Y., Z.H., R.C., Y.Y., J.S., Z.M., N.M.)
cChina National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China
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K. Kang
bNeurology (K.K., Y.W.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
cChina National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China
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R. Cui
aFrom the Department of Interventional Neuroradiology (M.W., L.Y., Z.H., R.C., Y.Y., J.S., Z.M., N.M.)
cChina National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China
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Y. Yu
aFrom the Department of Interventional Neuroradiology (M.W., L.Y., Z.H., R.C., Y.Y., J.S., Z.M., N.M.)
cChina National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China
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J. Song
aFrom the Department of Interventional Neuroradiology (M.W., L.Y., Z.H., R.C., Y.Y., J.S., Z.M., N.M.)
cChina National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China
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F.K. Hui
gDepartment of Radiology and Radiological Sciences (F.K.H.), Johns Hopkins Hospital, Baltimore, Maryland
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Y. Wang
bNeurology (K.K., Y.W.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
cChina National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China
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Z. Miao
aFrom the Department of Interventional Neuroradiology (M.W., L.Y., Z.H., R.C., Y.Y., J.S., Z.M., N.M.)
cChina National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China
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X. Lou
eDepartment of Radiology (X.L.), Chinese PLA General Hospital, Beijing, China
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N. Ma
aFrom the Department of Interventional Neuroradiology (M.W., L.Y., Z.H., R.C., Y.Y., J.S., Z.M., N.M.)
cChina National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China
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Article Figures & Data

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  • FIG 1.
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    FIG 1.

    Stump condition: tapered stump (A), blunt stump (B), no stump (C)

  • FIG 2.
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    FIG 2.

    An adult man who presented with blurred vision for 1 month and right-limb weakness for 10 days. On DSA, the occluded segment is from C1 (B) to C6 (A). On VWI, 3D T1-weighted turbo spin-echo sequences show that the occluded segment is C1 (arrow) to C6 (arrow) (C). The signal intensity of the distal segment in a elliptical region-of-interest (ROI) (D), and the signal intensity of the origin segment is heterogeneous intensity in a elliptical ROI (E).

  • FIG 3.
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    FIG 3.

    An adult woman who presented with dizziness for 2 months. On DSA, the occluded segment is from C1 (B) to C7 (A). On VWI, 3D T1-weighted turbo spin-echo sequences show that the occluded segment was C2 (arrow) to C4 (arrow), and C1 did not have total occlusion (arrowheads, C). The signal intensity of distal segment is isointensity in a elliptical region-of-interest (ROI) (D). The origin segment showed a tiny lumen (arrowhead), in a circular ROI which was considered an occluded segment on DSA (E).

Tables

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    Table 1:

    Baseline data of patients with asymptomatic and symptomatic CCAO

    Asymptomatic (n = 9)Symptomatic (n = 35)P Value
    Male (No.) (%)8 (88.9)34 (97.1).37
    Age (mean) (yr)59 (SD, 13.35)60.51 (SD, 11.46).73
    Body mass index (mean)25.30 (SD, 3.49)24.40 (SD, 3.12).46
    Hypertension (No.) (%)7 (77.8)26 (74.3)>.99
    Diabetes mellitus (No.) (%)3 (33.3)12 (34.3)>.99
    Hyperlipidemia (No.) (%)7 (77.8)28 (80.0)>.99
    Coronary artery disease (No.) (%)1 (11.1)3 (8.6)>.99
    Smoker (No.) (%)4 (44.4)15 (42.9)>.99
    Antithrombotic treatment before diagnosis of CCAO (No.) (%)1 (11.1)8 (22.9).75
    Antithrombotic treatment after diagnosis of CCAO (No.) (%)3 (33.3)18 (51.4).55
    History of radiation (No.) (%)0 (0.0)1 (2.9)>.99
    Time intervals between DSA and VWI (median) (IQR) (days)1 (1, 2.5)2 (1, 4).74
    • Note:—IQR indicates interquartile range.

    • View popup
    Table 2:

    Difference in signal intensity at the origin segment of symptomatic CCAO at different stages

    Hyperintensity (n = 0)Isointensity (n = 7)Hypointensity (n = 0)Heterogeneous Intensity (n = 27)P Value
    <7 days (No.) (%)0 (0.0)0 (0.0)0 (0.0)5 (14.7).69
    7–30 days (No.) (%)0 (0.0)4 (57.1)0 (0.0)16 (47.1)
    30–90 days (No.) (%)0 (0.0)2 (28.6)0 (0.0)10 (29.4)
    ≥90 days (No.) (%)0 (0.0)1 (14.3)0 (0.0)3 (8.8)
    • View popup
    Table 3:

    Difference in signal intensity at the distal segment of symptomatic CCAO at different stages

    Hyperintensity(n = 9)Isointensity (n = 14)Hypointensity (n = 0)Heterogeneous Intensity (n = 12)P Value
    <7 days (No.) (%)2 (22.2)1 (7.1)0 (0.0)2 (16.7).29
    7–30 days (No.) (%)2 (22.2)6 (42.9)0 (0.0)8 (67.7)
    30–90 days (No.) (%)4 (44.4)4 (28.6)0 (0.0)2 (16.7)
    ≥90 days (No.) (%)1 (11.1)3 (21.4)0 (0.0)0 (0.0)
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American Journal of Neuroradiology: 43 (1)
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M. Wan, L. Yan, Z. Xu, Z. Hou, K. Kang, R. Cui, Y. Yu, J. Song, F.K. Hui, Y. Wang, Z. Miao, X. Lou, N. Ma
Symptomatic and Asymptomatic Chronic Carotid Artery Occlusion on High-Resolution MR Vessel Wall Imaging
American Journal of Neuroradiology Jan 2022, 43 (1) 110-116; DOI: 10.3174/ajnr.A7365

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Symptomatic and Asymptomatic Chronic Carotid Artery Occlusion on High-Resolution MR Vessel Wall Imaging
M. Wan, L. Yan, Z. Xu, Z. Hou, K. Kang, R. Cui, Y. Yu, J. Song, F.K. Hui, Y. Wang, Z. Miao, X. Lou, N. Ma
American Journal of Neuroradiology Jan 2022, 43 (1) 110-116; DOI: 10.3174/ajnr.A7365
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