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Preliminary Observations Using Rapid Sequential Computerized Tomographic Scanning

Thomas S. Riles, MD; Marc P. Posner, MD; Wendy S. Cohen, MD; Richard Pinto, MD; Anthony M. Imparato, MD; F. Gregory Baumann, PhD

Arch Surg. 1982;117(9):1185-1188.

Abstract
• Cerebral angiography often cannot distinguish between complete thrombosis or fibrosis of the internal carotid artery (ICA) and nonvisualization due to a total occlusion of the common carotid or origin of the ICA. Whereas surgery may be beneficial if the distal carotid is patent (type 1), thromboendarterectomy may be contraindicated if thrombus or fibrosis extend to the intracranial branches (type 2). Rapid sequential computerized tomography (RSCT) was used to examine 15 patients whose ICAs appeared occluded by angiography. Of four ICAs classed as type 1 by RSCT, three were found to be patent during surgical exploration, and carotid reconstruction was successfully performed. Three other ICAs classed as type 2 by RSCT were also surgically explored, and complete thrombosis was confirmed. The RSCT technique provides an effective and nonoperative means of determining whether a nonvisualized ICA is reconstructible.

(Arch Surg 1982;117:1185-1188)

Author Affiliations
From the Departments of Surgery (Drs Riles, Posner, Imparato, and Baumann) and Radiology (Drs Cohen and Pinto), New York University, New York.

Footnotes
Accepted for publication March 12, 1982.

Reprint requests to 530 First Ave, Suite 6F, New York, NY 10016 (Dr Riles).

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