Concurrent Stenoocclusive Disease of Intracranial and Extracranial Arteries in a Patient with Polycythemia Vera
Figure 1
Multimodality imaging demonstrating stenoocclusive disease of intracranial and extracranial arteries. (a) CT angiogram chest demonstrating complete occlusion of left subclavian artery (arrow) with distal filling from left VA (arrowhead). Remainder of VA is out of plane of view, but patent distally. (b) MR Angiogram of abdomen demonstrating bilateral renal artery stenoses (arrows). (c) Time-of-flight MR angiogram of head showing absence of bilateral MCA vessels and decreased flow of both ICAs. The posterior circulation is relatively plethoric. (d) Conventional angiogram of the right ICA (AP projection) showing typical moyamoya appearance of intracranial occlusion of supraclinoid ICA (arrow) with reconstitution of the MCA via multiple small moyamoya collaterals (arrowhead). (e) Right subclavian digital subtraction angiogram demonstrating high-grade (>70%) right VA stenosis (arrow).
