Fusion Technique Using Three-Dimensional Digital Subtraction Angiography in the Evaluation of Complex Cerebral and Spinal Vascular Malformations

2016 ◽  
Vol 85 ◽  
pp. 353-358 ◽  
Author(s):  
Kenji Fukuda ◽  
Toshio Higashi ◽  
Masakazu Okawa ◽  
Mitsutoshi Iwaasa ◽  
Hiroshi Abe ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Vascular Malformations ◽  
Three Dimensional ◽  
Digital Subtraction ◽  
Fusion Technique ◽  
Spinal Vascular Malformations

Intraoperative Spinal Digital Subtraction Angiography: Technique and Results

Neurosurgery ◽  
2003 ◽  
Vol 52 (3) ◽  
pp. 603-609 ◽  
Author(s):  
Ludwig Benes ◽  
Jörg-Peter Wakat ◽  
Ulrich Sure ◽  
Siegfried Bien ◽  
Helmut Bertalanffy
Keyword(s):  
Digital Subtraction Angiography ◽  
Wound Closure ◽  
Vascular Malformations ◽  
Vascular Anatomy ◽  
Vascular Lesions ◽  
Digital Subtraction ◽  
Segmental Artery ◽  
Spinal Vascular Malformations ◽  
Clinical Records ◽  
Methodological Aspects

Abstract OBJECTIVE To evaluate technical and methodological aspects of intraoperative spinal digital subtraction angiography (ISDSA) in our clinical practice and to assess its practicability, safety, and accuracy for the surgical treatment of spinal vascular malformations. METHODS Between August 1997 and February 2002, a total of 30 patients were treated either surgically (n = 18) or endovascularly (n = 12) for spinal vascular lesions at our institution. The clinical records of five patients who underwent ISDSA were analyzed retrospectively. The thoracic segment was involved in three patients and the medullary cone in two. RESULTS ISDSA could be performed in four cases. In one patient, the segmental artery could not be probed sufficiently while the patient was prone. No complications occurred from the application of ISDSA. The method was beneficial for the neurosurgeon in all but one patient because the vascular anatomy of the malformation was shown with respect to the surgical approach, including the nidus, and immediate resection control could be performed before wound closure. The duration of the procedure was prolonged by 45 minutes on average. CONCLUSION ISDSA is safe and effective, especially in surgery for complex vascular and recurrent malformations. Benefits to the patient outweigh the additional expense and prolongation of the surgical procedure.

scholarly journals Four-dimensional digital subtraction angiography for exploration of spinal cord vascular malformations: preliminary experience

2020 ◽  
Vol 13 (1) ◽  
pp. 69-74
Author(s):  
Frédéric Clarençon ◽  
Stéphanie Lenck ◽  
Eimad Shotar ◽  
Anne-Laure Boch ◽  
Etienne Lefevre ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Vascular Malformations ◽  
Venous Drainage ◽  
Digital Subtraction ◽  
Drainage Pattern ◽  
Arteriovenous Fistulas ◽  
Spinal Vascular Malformations ◽  
Precise Understanding ◽  
Spinal Dural Arteriovenous Fistulas ◽  
Spinal Epidural

BackgroundThe precise understanding of the angioarchitecture of spinal vascular malformations (SVMs) is often difficult to reach with conventional digital subtraction angiography (DSA). The purpose of our study was to evaluate the potential of four-dimensional DSA (4D-DSA) (Siemens Healthcare) in the exploration of SVMs.MethodsWe retrospectively studied all patients who underwent spinal DSA, including 4D-DSA acquisition, from July 2018 to June 2019 at a single institution. All spinal DSA acquisitions were performed under general anesthesia. 4D-DSA acquisitions were acquired with the protocol '12 s DSA Dyna4D Neuro'. 12 mL of iodixanol 320 mg iodine/mL were injected via a 5 F catheter (1 mL/s during the 12 s 4D-DSA acquisition). Inter-rater (three independent reviewers) and intermodality agreements were assessed.ResultsNine consecutive patients (six men, three women, mean age 55.3±19.8 years) with 10 SVMs (spinal dural arteriovenous fistulas n=3, spinal epidural arteriovenous fistulas n=2, spinal pial arteriovenous fistulas n=2, and spinal arteriovenous malformations n=2; one patient had two synchronous pial fistulas) had spinal DSA, including 4D-DSA acquisition. Inter-rater agreement was good and moderate for the venous drainage pattern and the SVM subtype, respectively. In 9 of 10 cases, the quality of the acquisition was graded as good. Satisfactory concordance between 4D-DSA and the selective microcatheterization was observed in 90% of cases for the location of the shunt point.Conclusion4D-DSA acquisition may be helpful for a better understanding of the angioarchitecture of SVMs. Larger series are warranted to confirm these preliminary results.

scholarly journals Value of Three-Dimensional Digital Subtraction Angiography for Detection and Classification of Intracranial Aneurysm Remnants After Clipping

2021 ◽  
Author(s):  
Serge Marbacher ◽  
Matthias Halter ◽  
Deborah R Vogt ◽  
Jenny C Kienzler ◽  
Christian T J Magyar ◽  
...  
Keyword(s):  
Intracranial Aneurysm ◽  
Digital Subtraction Angiography ◽  
Diagnostic Yield ◽  
Three Dimensional ◽  
P Value ◽  
Digital Subtraction ◽  
Patient Demographics ◽  
Included Patient ◽  
2D And 3D

Abstract BACKGROUND The current gold standard for evaluation of the surgical result after intracranial aneurysm (IA) clipping is two-dimensional (2D) digital subtraction angiography (DSA). While there is growing evidence that postoperative 3D-DSA is superior to 2D-DSA, there is a lack of data on intraoperative comparison. OBJECTIVE To compare the diagnostic yield of detection of IA remnants in intra- and postoperative 3D-DSA, categorize the remnants based on 3D-DSA findings, and examine associations between missed 2D-DSA remnants and IA characteristics. METHODS We evaluated 232 clipped IAs that were examined with intraoperative or postoperative 3D-DSA. Variables analyzed included patient demographics, IA and remnant distinguishing characteristics, and 2D- and 3D-DSA findings. Maximal IA remnant size detected by 3D-DSA was measured using a 3-point scale of 2-mm increments. RESULTS Although 3D-DSA detected all clipped IA remnants, 2D-DSA missed 30.4% (7 of 23) and 38.9% (14 of 36) clipped IA remnants in intraoperative and postoperative imaging, respectively (95% CI: 30 [ 12, 49] %; P-value .023 and 39 [23, 55] %; P-value = <.001), and more often missed grade 1 (< 2 mm) clipped remnants (odds ratio [95% CI]: 4.3 [1.6, 12.7], P-value .005). CONCLUSION Compared with 2D-DSA, 3D-DSA achieves a better diagnostic yield in the evaluation of clipped IA. Our proposed method to grade 3D-DSA remnants proved to be simple and practical. Especially small IA remnants have a high risk to be missed in 2D-DSA. We advocate routine use of either intraoperative or postoperative 3D-DSA as a baseline for lifelong follow-up of clipped IA.

Intraoperative digital subtraction angiography and the surgical treatment of intracranial aneurysms and vascular malformations

1990 ◽  
Vol 73 (4) ◽  
pp. 526-533 ◽  
Author(s):  
Neil A. Martin ◽  
John Bentson ◽  
Fernando Viñuela ◽  
Grant Hieshima ◽  
Murray Reicher ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Intracranial Aneurysms ◽  
Vascular Malformations ◽  
Operating Table ◽  
Digital Subtraction ◽  
Intraoperative Angiography ◽  
Content Type ◽  
Head Holder ◽  
Cerebral Embolization ◽  
Leg Ischemia

✓ Intraoperative digital subtraction angiography using commercially available equipment was employed to confirm the precision of the surgical result in 105 procedures for intracranial aneurysms or arteriovenous malformations (AVM's). Transfemoral selective arterial catheterization was performed in most of these cases. A radiolucent operating table was used in all cases, and a radiolucent head-holder in most. In five of the 57 aneurysm procedures, clip repositioning was required after intraoperative angiography demonstrated an inadequate result. In five of the 48 AVM procedures, intraoperative angiography demonstrated residual AVM nidus which was then located and resected. In two cases intraoperative angiography failed to identify residual filling of an aneurysm which was seen later on postoperative angiography, and in one case the intraoperative study failed to demonstrate a tiny residual fragment of AVM which was seen on conventional postoperative angiography. Two complications resulted from intraoperative angiography: one patient developed aphasia from cerebral embolization and one patient developed leg ischemia from femoral artery thrombosis. This technique appears to be of particular value in the treatment of complex intracranial aneurysms and vascular malformations.

scholarly journals Estimation of the number of feeding arteries of spinal arteriovenous malformations by using three-dimensional digital subtraction angiography

2018 ◽  
Vol 28 (4) ◽  
pp. 842-848 ◽  
Author(s):  
Soichiro Takamiya ◽  
Toshiya Osanai ◽  
Toshitaka Seki ◽  
Noriyuki Fujima ◽  
Kazutoshi Hida ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Arteriovenous Malformations ◽  
Three Dimensional ◽  
Digital Subtraction ◽  
Spinal Arteriovenous Malformations

scholarly journals Four-dimensional digital subtraction angiography for exploration of intraosseous arteriovenous fistula in the sphenoid bone

2021 ◽  
Vol 12 ◽  
pp. 85
Author(s):  
Toshihiro Ishibashi ◽  
Fumiaki Maruyama ◽  
Issei Kan ◽  
Tohru sano ◽  
Yuichi Murayama
Keyword(s):  
Arteriovenous Fistula ◽  
Digital Subtraction Angiography ◽  
Three Dimensional ◽  
Sphenoid Bone ◽  
External Carotid ◽  
Digital Subtraction ◽  
Fused Image ◽  
Initial Imaging ◽  
Bilateral Abducens Palsy ◽  
Bilateral Abducens

Background: Intraosseous arteriovenous fistula (AVF) is a rare clinical entity that typically presents with symptoms from their effect on surrounding structures. Here, we report a case of intraosseous AVF in the sphenoid bone that presented with bilateral abducens palsy. Case Description: A previously healthy man presented with tinnitus for 1 month, and initial imaging suspected dural AVF of the cavernous sinus. Four-dimensional digital subtraction angiography (4D-DSA) imaging and a three-dimensional (3D) fused image from the bilateral external carotid arteries revealed that the shunt was in a large venous pouch within the sphenoid bone that was treated through transvenous coil embolization. His symptoms improved the day after surgery. Conclusion: This is a case presentation of intraosseous AVF in the sphenoid bone and highlights the importance of 4D-DSA and 3D fused images for planning the treatment strategy.

Anatomical Reconstruction of Cerebral Vessels as Numerical Grid Models Using Three-dimensional Digital Subtraction Angiography

2003 ◽  
Vol 16 (5) ◽  
pp. 961-964
Author(s):  
T. Hassan ◽  
T. Saito ◽  
E. Timofeev ◽  
M. Ezura ◽  
A. Takahashi ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Three Dimensional ◽  
Cerebral Vessels ◽  
Anatomical Reconstruction ◽  
Digital Subtraction ◽  
Numerical Grid

Comparison of Intra- and Postoperative 3-Dimensional Digital Subtraction Angiography in Evaluation of the Surgical Result After Intracranial Aneurysm Treatment

Neurosurgery ◽  
2019 ◽  
Vol 87 (4) ◽  
pp. 689-696 ◽  
Author(s):  
Serge Marbacher ◽  
Jenny C Kienzler ◽  
Itai Mendelowitsch ◽  
Donato D’Alonzo ◽  
Lukas Andereggen ◽  
...  
Keyword(s):  
Image Quality ◽  
Intracranial Aneurysm ◽  
Digital Subtraction Angiography ◽  
Three Dimensional ◽  
Standard Of Care ◽  
Digital Subtraction ◽  
Factors Affecting ◽  
Imaging Quality ◽  
3 Dimensional ◽  
Surgical Result

Abstract BACKGROUND Postoperative three-dimensional digital subtraction angiography (3D-DSA) is the gold standard in evaluating intracranial aneurysm (IA) remnants after clipping. Should intraoperative 3D-DSA image quality be equally good as postoperative 3D-DSA, it could supplant the latter as standard of care for follow-up of clipped IA. OBJECTIVE To directly compare the quality of assessment of clipped IA by intraoperative and postoperative 3D-DSA. METHODS From a prospective cohort of 221 consecutive patients who underwent craniotomy for IA treatment in a hybrid operating room, we retrospectively studied 26 patients who had both intraoperative and postoperative 3D-DSA imaging of their clipped aneurysm. Comparison of intraoperative and postoperative 3D-DSA images (blinded for review) included parameters that affected image quality and differences between the 2 periods. RESULTS In the 26 patients with 32 clipped IAs, the mean interval was 11 ± 7 mo between intraoperative and postoperative imaging 3D-DSA examinations. Reconstruction with multiple clips was used in 14 (44%) cases. Of 15 remnants, 9 (60%) were small (<2 mm). In comparing intraoperative and postoperative 3D-DSA, no discordance or discrepancy in assessment of the surgical result was noted for any clipped IA, and overall imaging quality was excellent for both modalities. Factors affecting minor differences in image quality were not identified. CONCLUSION Compared with postoperative 3D-DSA, intraoperative 3D-DSA images achieved equally high quality and effective, immediate interpretation of the surgical clipping result. With comparable imaging quality and no discordant findings, intraoperative 3D-DSA could replace postoperative 3D-DSA to become the standard of care in IA surgery.

Sign in / Sign up

Export Citation Format

Share Document