ArticleAJNR. American journal of neuroradiology2018
Accuracy of CT Angiography for Differentiating Pseudo-Occlusion from True Occlusion or High-Grade Stenosis of the Extracranial ICA in Acute Ischemic Stroke: A Retrospective MR CLEAN Substudy.
Article in AJNR. American journal of neuroradiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Endovascular Thrombectomy for Carotid Pseudo-Occlusion in the Setting of Acute Ischemic Stroke: A Comparative Systematic Review and Meta-analysis.AJNR. American journal of neuroradiology · 2024Pooled it
- Trial
- CTA-based imaging parameters for differentiating tandem from isolated internal carotid artery occlusion: development of a multivariable prediction model.Neuroradiology · 2026Article
- Endovascular thrombectomy for subterminal internal carotid artery occlusions: clinical and radiological heterogeneity in a nationwide registry.Neuroradiology · 2026Article
- Distinction between acute and chronic carotid disease based on computed tomography angiography in acute ischemic stroke patients with carotid artery occlusion.BMC neurology · 2026Article
- True versus pseudo-occlusion of the cervical internal carotid artery in acute stroke: A multicenter MR angiography study.European stroke journal · 2026Article
- True versus pseudo-occlusion of the cervical internal carotid artery in acute stroke: A multicenter MR angiography study.European stroke journal · 2025Article
- Carotid Stump Syndrome: A Case That Highlights the Necessity of Digital Subtraction Angiography for the Prompt Management of the Syndrome.Diagnostics (Basel, Switzerland) · 2025Article
- Differentiation of Acute Internal Carotid Artery Occlusion Etiology on Computed Tomography Angiography: Diagnostic Tree for Preparing Endovascular Treatment.Diagnostics (Basel, Switzerland) · 2024Article
- Accuracy of Computed Tomography Angiography for Diagnosing Extracranial Mural Lesions in Patients with Acute Internal Carotid Artery Occlusion: Correlation with Digital Subtraction Angiography.Journal of personalized medicine · 2023Article
- Acute intracranial internal carotid artery occlusion: Extension and location of the thrombus as an influencing factor in Computed Tomography angiography findings.European journal of radiology open · 2023Article
- Endovascular Recanalization of Tandem Internal Carotid Occlusions Using the Balloon-assisted Tracking Technique.Clinical neuroradiology · 2022Article
- The potential role of diffusion weighted imaging in the diagnosis of early carotid and vertebral artery dissection.Neuroradiology · 2022Article
- Factors Distinguishing Proximal and Distal Internal Carotid Artery Occlusions in Patients with Acute Ischemic Stroke.Diagnostics (Basel, Switzerland) · 2022Article
- Diagnosis and treatment of acute isolated proximal internal carotid artery occlusions: a narrative review.Therapeutic advances in neurological disorders · 2022Review
- Outcomes in acute ischemic stroke patients undergoing endovascular thrombectomy: Cervical internal carotid artery pseudo-occlusion vs. true occlusion.Frontiers in neurology · 2022Article
- High-resolution magnetic resonance imaging for predicting successful recanalization in patients with chronic internal carotid artery occlusion.Frontiers in neurology · 2022Article
- Difference of Thrombus Location between Initial Noninvasive Vascular Image and First DSA Findings in Mechanical Thrombectomy for Intracranial Large Vessel Occlusion: Post Hoc Analysis of the SKIP Study.Neurologia medico-chirurgica · 2021Article
- Evaluation of the interrater and intermethod agreement of the German multiparametric ultrasound criteria for the grading of internal carotid artery stenosis.Neuroradiology · 2021Article
- Tandem Carotid Lesions in Acute Ischemic Stroke: Mechanisms, Therapeutic Challenges, and Future Directions.AJNR. American journal of neuroradiology · 2020Review
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeThe absence of opacification on CTA in the extracranial ICA in acute ischemic stroke may be caused by atherosclerotic occlusion, dissection, or pseudo-occlusion. The latter is explained by sluggish or stagnant flow in a patent artery caused by a distal intracranial occlusion. This study aimed to explore the accuracy of CTA for differentiating pseudo-occlusion from true occlusion of the extracranial ICA. MATERIALS AND
methodsAll patients from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) with an apparent ICA occlusion on CTA and available DSA images were included. Two independent observers classified CTA images as atherosclerotic cause (occlusion/high-grade stenosis), dissection, or suspected pseudo-occlusion. Pseudo-occlusion was suspected if CTA showed a gradual contrast decline located above the level of the carotid bulb, especially in the presence of an occluded intracranial ICA bifurcation (T-occlusion). DSA images, classified into the same 3 categories, were used as the criterion standard.
resultsIn 108 of 476 patients (23%), CTA showed an apparent extracranial carotid occlusion. DSA was available in 46 of these, showing an atherosclerotic cause in 13 (28%), dissection in 16 (35%), and pseudo-occlusion in 17 (37%). The sensitivity for detecting pseudo-occlusion on CTA was 82% (95% CI, 57-96) for both observers; specificity was 76% (95% CI, 56-90) and 86% (95% CI, 68-96) for observers 1 and 2, respectively. The κ value for interobserver agreement was .77, indicating substantial agreement. T-occlusions were more frequent in pseudo- than true occlusions (82% versus 21%,
conclusionsOn CTA, extracranial ICA pseudo-occlusions can be differentiated from true carotid occlusions.
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