MR angiography in the follow-up of coiled cerebral aneurysms after treatment with guglielmi detachable coils

2002 ◽  
Vol 43 (1) ◽  
pp. 10-14 ◽  
Author(s):  
T. Nome ◽  
S.J. Bakke ◽  
P.H. Nakstad
1998 ◽  
Vol 11 (1) ◽  
pp. 19-25 ◽  
Author(s):  
E. Cotroneo ◽  
M. Dazzi ◽  
R. Gigli ◽  
G. Guidetti ◽  
G.P. Cantore ◽  
...  

Thirteen cases of cerebral aneurysms submitted to endovascular treatment using Guglielmi detachable coils (GDC) are described. Control MRI-angiography 3D TOF was performed three and six months later. In order to spare patients the discomfort and risks related to repeated trauma and iodate contrast injection, we examined the possibility of an alternative non-invasive diagnostic method. For this purpose, the digital subtraction angiograms performed three and six months after embolisation were compared with the MR-angiograms obtained in the same period, all using the same tomograph at middle field intensity (0.5T). We discuss the outcome of this comparison and the limits of the MR-angiography method in the follow-up of aneurysms submitted to endovascular treatment.


2004 ◽  
Vol 10 (1_suppl) ◽  
pp. 161-166 ◽  
Author(s):  
Y. Nakai ◽  
M. Sonobe ◽  
T. Takigawa ◽  
T. Yamazaki ◽  
S. Okamoto ◽  
...  

Acute angiographical changes for preventing acute rebleeding on GDC treated cerebral aneurysms were evaluated. From December 2000 to November 2002, 48 total aneurysms in 44 consecutive patients with acute SAH. Acute angiographical evaluations were carried out in 46 aneurysms, including 42 ruptured and 4 unruptured aneurysms. Two cases were excluded because of poor medical condition. In this series, there were no rebleeding cases in acute stage. In the initial embolization for the 46 aneurysms, CO was achieved in eight aneurysms, NR in 15 aneurysms and BF in 23 aneurysms. Acute angiographical observations showed progressive thrombosis in 17 aneurysms (37%). No changes were observed in remaining 29. No recanalization was observed in this series. Only one case of BF, inside the aneurysm bleb was still observed during follow up. Additional embolization was carried out. Progressive thrombosis was frequently observed in GDC treated cerebral aneurysms during acute stage. This angiographical finding seems to show prevention of rebleeding, which is considered important for the management of GDC treatment in acutely ruptured cerebral aneurysm.


2006 ◽  
Vol 12 (1_suppl) ◽  
pp. 45-48 ◽  
Author(s):  
T. Saguchi ◽  
Y. Murayama ◽  
T. Ishibashi ◽  
M. Ebara ◽  
K. Irie ◽  
...  

A follow-up of the embolized cerebral aneurysm with Guglielmi Detachable Coils (GDC) were performed mainly using craniograms and digital subtraction angiograms (DSA) so far. Recently, several authors have reported about efficacy of the time of flight (TOF) magnetic resonance angiogram (MRA) as a follow-up for the embolized cerebral aneurysms. In our institution, 3-D reconstructed TOF MRAs have been performed as a follow-up of the embolized cerebral aneurysms. We examined efficacy of 3-D reconstructed TOF MRA. 3-D TOF MRA was performed for a follow-up of the embolized cerebral aneurysms at our outpatient clinic in 35 patients. Morphological examination of the 3-D images between 3-D TOF MRA and 3-D DSA was performed. Almost similar images of 3-D MRA were obtained after 3-D reconstruction as compared with those of 3-D DSA. In three cases, recanalization was suspected in the 3-D TOF MRA. And recanalization was confirmed in the 3-D DSA actually. A quality of 3-D TOF MRA for a diagnosis of recanalization was good and practical. However, in two cases, arteries were partially disappeared in the 3-D TOF MRA. These were the artifact due to coil mass and this is a current limitation of 3-D TOF MRA. The images of 3-D TOF MRA that were reconstructed in the 3-D workstation were very similar to those of 3-D DSA. 3-D reconstructed TOF MRA was very useful for a less-invasive diagnosis of a recanalization of the embolized cerebral aneurysms.


1999 ◽  
Vol 23 (2) ◽  
pp. 216-223 ◽  
Author(s):  
Laurent Brunereau ◽  
Jean-Philippe Cottier ◽  
Catherine-Brigitte Sonier ◽  
Bernard Medioni ◽  
Philippe Bertrand ◽  
...  

2003 ◽  
Vol 9 (1_suppl) ◽  
pp. 47-50 ◽  
Author(s):  
Y. Nakai ◽  
M. Sonobe ◽  
K. Sugita ◽  
Y. Matsumaru

The purpose of this study is to evaluate the mid or long-term angiographical stability of Guglielmi Detachable Coils (GDC) after embolization for cerebral aneurysms. Between march 1997 and november 2001, 164 aneurysms, including 116 ruptured and 48 unruptured aneurysms, were treated using GDC at Mito National Hospital. Cerebral angiograms over one month after embolization were obtained in 111 aneurysms, including 71 ruptured and 40 unruptured aneurysms. At the time of initial GDC embolization of the 71 ruptured aneurysms, complete occlusion was achieved in 31 aneurysms, neck remnant in 18 aneurysms, and body filling in 22 aneurysms. Morphological changes were observed in 26 aneurysms (37%) in follow-up. Progressive thrombosis was obtained in 12 out of 71 aneurysms, no changes were shown in 45, and recanalizations occurred in 14. In the initial embolization of the 40 unruptured aneurysms, complete occlusion was achieved in 15 aneurysms, neck remnant in five and body filling in 20 aneurysms respectively. Morphological changes were observed in 12 aneurysms (30%), in which 12 aneurysms showed progressive thrombosis and 28 aneurysms were unchanged. There were significant differences of the long-term angiographical stability between ruptured and unruptured aneurysms. Rigorous follow-up angiography is mandatory when complete aneurysm occlusion is not achieved in ruptured aneurysms.


2001 ◽  
Vol 7 (1_suppl) ◽  
pp. 65-72 ◽  
Author(s):  
T. Hayashi ◽  
J. Asai ◽  
H. Sugimoto ◽  
M. Honda ◽  
K. Satoh ◽  
...  

The purpose of this study is to evaluate the perfusional state of cerebral aneurysms treated by platinum detachable coils using three different techniques of MR angiography (MRA), and to compare the results of each MRA technique. Thirty examinations were investigated in twelve patients. They were three men and nine women, and their average age was 67y.o. They were all treated by platinum detachable coils for cerebral aneurysms. We obtained three different types of MRA on the same day; 2D-FSPGR Gd-DTPA enhanced dynamic MRA, 3D-TOF MRA with and without Gd-DTPA enhancement. On 2D FSPGR enhanced dynamic MRA, we used the first pass arterial phase for judgement that did not overlap the venous phase. In each study, we evaluated parent artery flow, branch artery flow, residual flow in coils, and residual neck. Digital subtraction angiography (DSA) was used as gold standard. On 3D-TOF MRA examinations without enhancement, parent artery flow was correctly identified with an accuracy of 96.7% with DSA confirmation. Branch artery flow was identified with an accuracy of 91.3%. Flow in the coils was correctly identified with an accuracy of 86.7%. Residual neck was correctly evaluated with an accuracy of 83.3%. On 3D-TOF MRA with enhancement, parent artery flow was correctly identified with an accuracy of 96.7%. Branch artery flow was identified with an accuracy of 91.3%. Flow in the coils was correctly identified with an accuracy of 93.3%. Residual neck was correctly identified with an accuracy of 86.7%. On 2D FSPGR enhanced dynamic MRA, parent artery flow was correctly identified with an accuracy of 100%. Branch artery flow was identified with an accuracy of 94.2%. Flow in the coils was correctly identified with an accuracy of 96.7%. Residual neck was correctly evaluated with an accuracy of 100%. Parent artery flow, branch artery flow, residual flow in coils, and residual necks were seen more accurately with 2D-FSPGR Gd-DTPA enhanced dynamic MRA than 3D-TOF MRA with and without enhancement. With T1 shortening effect of Gd-DT-PA and first pass arterial phase of 2D-FSPGR enhanced dynamic MRA techniques, we could evaluate more accurately the perfusional status of platinum-coil-treated cerebral aneurysms and arteries adjacent to the aneurysms than with non enhanced or enhanced 3D TOF MRA.


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