Extracranical Carotid Arteries and Arch Vessels

Abstract

Catheter-based angiographic techniques have been the gold standard for diagnosis of carotid bulb disease. It provides projection images of the carotid bulb, which were the sole basis for treatment decisions in the NASCET and ESCT trials. Digital subtraction angiography (DSA) has several limitations, foremost of which is an approximately 1 percent incidence of significant stroke caused by selective arterial catheterization. In addition, the DSA method is primarily implemented as a projection of the vascular lumen. Measurement of the percent stenosis varies by observer and by projection. These issues have motivated the development of less invasive cross-sectional methods for imaging the carotid bifurcation using MRA.