Abstract Details

Title To CTA or Not to CTA: Should We Continue to Order CT Angiography of Head and Neck in Patients with TIA?

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-048

Objective To determine whether CT Angiography (CTA) Head/Neck significantly changes treatment or management in patients with Transient Ischemic Attacks (TIA).

Background There has been increasing evidence that detecting intracranial stenosis and occlusion in patients with TIA can be useful as a risk-stratification tool for predicting future strokes. We explore whether the discovery of intracranial stenosis or occlusion altered the management of TIA patients at our institution.

Design/Methods We conducted a retrospective chart review of 63 patients between 10/5/2015 - 5/6/2018, who presented to University Hospital and had a final diagnosis of TIA. Patients who had CTA Head/Neck or CDUS were included in the study. Studies which found occlusion, stenosis or narrowing intracranially or extracranially (in the case of CTA) were considered positive. Data about interventions as a result of these diagnostic tests were endpoints.

Results Of 63 confirmed TIA patients, 46 (73%) had CTA Head/Neck, 19 (30.2%) had CDUS, and 8 (12.7%) had both. Of the patients who underwent CTA Head/Neck, 7 (15.2%) had only intracranial, 9 (19.6%) had only extracranial stenosis, occlusion, or narrowing and 8 (17.4%) had both. Of the patients who underwent CDUS, 2 (10.5%) had extracranial stenosis. Of the patients who had both CTA Head/Neck and CDUS, intracranial stenosis was detected on CTA Head/Neck in 2 (10.6%). Only two interventions were performed based on these results. One CTA finding resulted in a carotid endartectomy and 1 CDUS finding resulted in carotid stenting.

Conclusions While the yield of CTA Head in patients with TIA was high (37%), this did not change the management in a single person. The yield of CTA Neck was also high (32.6%) and changed the management in 1 person (2.2%). CTA Head/Neck do not appear to be useful in patients with TIA and replacing them with CDUS may be a more cost-effective option.

Authors/Disclosures
Ivo Bach, MD PRESENTER	Dr. Bach has nothing to disclose.
Anusha Boyanpally, MBBS	No disclosure on file
Sean P. Reilly	No disclosure on file
Machteld E. Hillen, MD, FAAN (Rutgers-NJMS)	The institution of Dr. Hillen has received research support from Genentech.

��ɫ��

��ɫ��