STROKE-ANGIOGRAPHY

SUMMARY

1. CTA or MRA is recommended to evaluate the intra- and extracranial vasculature of patients with TIA or stroke.

2. Both imaging modalities are significantly more sensitive and specific than carotid Doppler US for diagnosing extracranial vascular stenosis.

3. Carotid ultrasound also tends to overdiagnose lesions and leads to unnecessary surgery in some patients.

4. CTA is better than MRI at identifying intracranial aneurysms.

5. If performing CTA or MRA doesn't extend the time period from symptom onset out past 4.5 hours maximum (< 3 hours best), either is recommended.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].