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AJNR - American Journal of Neuroradiology

Published ahead of print on May 22, 2008
doi: 10.3174/ajnr.A1126

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Carotid Artery Stenting for Calcified Lesions

M. Tsutsumi^a, H. Aikawa^a, M. Onizuka^a, M. Iko^a, T. Kodama^a, K. Nii^a, S. Hamaguchi^a, H. Etou^a, K. Sakamoto^a and K. Kazekawa^a

^a From the Department of Neurosurgery and Neuroradiology, Fukuoka University Chikushi Hospital, Fukuoka, Japan

View larger version (46K): [in this window] [in a new window]   Fig 1. Maximum intensity projection (A) and sagittal reformat (B) of a CT angiogram reveal left internal carotid artery (ICA) stenosis with severe calcification. The entire circumference of the ICA (C) and the circumference of the calcified plaque (D) on the axial source image are measured at the narrowest portion of the ICA. The arc (degree) of the calcification is calculated as: arc = external circumference of the calcified plaque/external circumference of the carotid artery x360°.

View larger version (60K): [in this window] [in a new window]   Fig 2. Illustrative case (an 81-year-old woman). A, Left common carotid artery (CCA) angiogram demonstrates severe stenosis of the internal carotid artery (ICA) with heavy calcification. B, The maximum intensity projection CT angiogram reveals severe calcification at the bifurcation of the carotid artery. C, At the narrowest portion of the ICA, the arc of the plaque calcification is 342°. D, Left CCA angiogram demonstrates excellent dilation. There is a 5% residual stenosis of the lesion after CAS.

View larger version (11K): [in this window] [in a new window]   Fig 3. The arc of calcium is plotted against the residual stenosis after CAS. The units represent the degrees of calcium arc by labeling the x-axis. There is a good correlation between these 2 variables (r = 0.6, P < .001).