Karotidna i vertebralna bolest VZS

Karotidna i vertebralna bolest VZS
26. aprila 2020. No Comments Predavanja,Interventna radiologija Sava Stajic

Prof. Dr sci.med. Sava Stajić

Video prezentacija Karotidna i vertebralna bolest VZS

ISCHAEMIC STROKE:
CAROTID AND VERTEBRAL ARTERY DISEASE

ISCHAEMIC STROKE MECHANISMS

  • HROMBOTIC(occlusive processes in situ)
    • large extra-cranial artery
    • large intra-cranial artery
    • small penetrating artery
  • EMBOLIC (particle from somewhere else)
    • cardiac origin  
    • intra-arterial
  • HYPOPERFUSION(failure of the heart to pump)

HOW TO STUDY?

Karotidna i vertebralna bolest VZS 2
KAROTIDNA I VERTEBRALNA BOLEST VZS
  • Clinical presentation
  • Expected underlying pathology
  • CT, CTA
  • MRI, MRA

DIAGNOSTIC METHODS

  • DUS
    • Non-invasive
    • Routine screening method for extra-cranial carotid artery disease
  •    DSA
    • Gold standard
    • Intra and extra-cranial artery disease
    • Risk of morbidity (up to 4% of neurological complications)
    • Higher cost

CTA and MRA havesensitivity and specificity> 95%, compared with DSA

  • CTA:
    • High dose of iodine contrast
  • MRA:
    • Higher cost

ARTERIAL PATHOLOGICAL PROCESSES RESPONSIBLE FOR ISCHAEMIC STROKE

  • ADULTS
    • atherosclerosis – most common cause
    • A. dissection
    • Small- vessels disease
    • Inflammatory and non-inflammatory vasculopathy
    • Vasomotor diseases (hypertension, eclampsia)
    • Arterial trauma
    • Arteriovenous malformations
    • Arterial aneurysms
    • Extension of tumors
  • CHILDEN
    • peri-natal hypoxic-ischemic encephalopathy – most common cause

DEGREE OF STENOSIS – DSA

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O autoru
Sava Stajic Doktor medicine, specijalista radiolog, Doktor medicinskih nauka, Mentor specijalističkih studija iz radiologije Profesor strukovnih studija, Oblast Medicina, uža naučna oblast Radiologija