scholarly journals 3D Rotational Angiography in Follow-Up of Clipped Intracranial Aneurysms

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Subhash Kumar ◽  
Shailesh B. Gaikwad ◽  
Nalini Kant Mishra
Keyword(s):  
Digital Subtraction Angiography ◽  
Intracranial Aneurysms ◽  
Detection Rate ◽  
Digital Subtraction ◽  
Rotational Angiography ◽  
3D Rotational Angiography ◽  
Aneurysm Morphology ◽  
Aneurysm Detection ◽  
Grade One

Introduction. 3D Rotational Angiography (RA) is indispensable for evaluation of intracranial aneurysms, providing infinite viewing angles and defining the aneurysm morphology. Its role in follow-up of clipped aneurysms remains unclear. We aimed to compare the aneurysm residue/recurrence detection rate of 3D RA with 2D digital subtraction angiography (DSA). Methods. 47 patients harboring 54 clipped aneurysms underwent both 2D DSA and 3D RA. The residual/recurrent aneurysms were classified into five grades and the images of both modalities were compared. Results. The residual/recurrent aneurysm detection rate was 53.70% (29/54 aneurysms) with 2D DSA and 66.67% (36/54 aneurysms) with 3D RA (P=0.05). In 12 aneurysms, 3D RA upgraded the residue/recurrence among which nine had been completely not detected on 2D DSA and were found to have grade one or two residual necks on the 3D RA, and, in three cases, a small neck on 2D DSA turned out to be aneurysm sac on 3D RA. In a total of 5 aneurysms, the classification was downgraded by 3D RA. Conclusion. 3D RA picks up more aneurysm residue/recurrence; hence, both 2D DSA and 3D RA should be performed in follow-up evaluation of clipped aneurysms.

scholarly journals Cost-Effectiveness of Magnetic Resonance Angiography Versus Intra-arterial Digital Subtraction Angiography to Follow-Up Patients With Coiled Intracranial Aneurysms

Stroke ◽  
2010 ◽  
Vol 41 (8) ◽  
pp. 1736-1742 ◽  
Author(s):  
Joanna D. Schaafsma ◽  
Hendrik Koffijberg ◽  
Erik Buskens ◽  
Birgitta K. Velthuis ◽  
Yolanda van der Graaf ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Digital Subtraction Angiography ◽  
Intracranial Aneurysms ◽  
Digital Subtraction

scholarly journals Necessity of follow-up cerebral digital subtraction angiography after endovascular coiling or microsurgical cliping of ruptured intracranial aneurysms to exclude de novo or aneurysmal regrow and avoid its rupture: report of 2 cases

2019 ◽  
Vol 27 (1) ◽  
pp. 12-20
Author(s):  
D.J. Gunia ◽  
E.T. Ekvtimishvili ◽  
G.Z. Basiladze
Keyword(s):  
Digital Subtraction Angiography ◽  
Intracranial Aneurysms ◽  
De Novo ◽  
Anterior Communicating Artery ◽  
Digital Subtraction ◽  
Treatment Results ◽  
First Case ◽  
De Novo Aneurysm ◽  
Brain Aneurysms

Objective – to improve treatment results of patients with ruptured brain aneurysms using follow-up cerebral digital subtraction angiography to avoid de novo or aneurismal regrow.Materials and methods. Analysis of follow-up cerebral digital subtraction angiography and treatment results of two patient (60 and 64-year-old females) with brain anterior communicated artery de novo aneurysm and regrowed aneurysm of an anterior communicated artery after microsurgical clipping.Results. Two patient underwent endovascular treatment of ruptured brain aneurysms after non follow-up cerebral digital subtraction angiography. In first case de novo aneurysm of anterior communicating artery and in second – regrowed aneurys of anterior communicating artery after surgical clipping. Both patients were discharged from the clinic in I and IV modified Rankin scale. Conclusions. Digital subtraction angiography follow-up of intracranial aneurysms treated by endovascular or microsurgical approach is important for the detection and prediction for the risk of bleeding (aneurysm recurrence and de novo aneurysm). There exist no guidelines on the frequency of monitoring and imaging modality to adopt and the monitoring is adapted on a case-by-case basis. Digital subtraction angiography is the gold standard for the evaluation of aneurysmal occlusion after coiling and microsurgical clipping and remains also necessary for evaluating other devices.

scholarly journals Value of 3D-DSA in the detection of intracranial aneurysms

2021 ◽  
Vol 57 (3) ◽  
pp. 260-268
Author(s):  
Darjan Franjić ◽  
Josip Mašković
Keyword(s):  
Digital Subtraction Angiography ◽  
Intracranial Aneurysms ◽  
Positive Relationship ◽  
Three Dimensional ◽  
Digital Subtraction ◽  
Neck Size ◽  
Aneurysm Neck ◽  
Aneurysm Detection ◽  
Aneurysmal Neck ◽  
Small Aneurysms

Aim: To determine the value of three-dimensional (3D) digital subtraction angiography (DSA) in the detection of intracranial aneurysms and to compare 3D technique with DSA. Materials and Methods: A retrospective analysis of 50 patients with 60 intracranial aneurysms who underwent both conventional DSA and 3D-DSA for the evaluation of intracranial aneurysms was conducted. The presence of aneurysms, detection of aneurysmal neck, size, location, presence of additional and small aneurysms analyzed from the two protocols were compared. Results: Three-dimensional technique detected 54 aneurysms while conventional DSA detected 38 aneurysms. There was no correlation between aneurysm detection and aneurysm neck detection in the two technologies observed, but there was a difference in detection performance depending on the technology used. Three-dimensional technique detected 52 aneurysm necks while conventional DSA detected 24 aneurysm necks. There was a statistically significant and positive relationship between the detected size of the aneurysm using 3D technique and DSA technology. Three-dimensional technique detected 24 additional aneurysms while conventional DSA detected only six additional aneurysms. Conclusions: Three-dimensional technique are more successful in the detection of aneurysms, their necks and small aneurysms in comparison to digital subtraction angiography, but difference is not statistically significant. The size of the aneurysm statistically significant affects the aneurysm neck detection by conventional DSA.

scholarly journals Intravenous versus intra-arterial digital subtraction angiography: Occlusion rate and complication assessment of experimental aneurysms after flow diverter treatment in rabbits

2018 ◽  
Vol 25 (2) ◽  
pp. 157-163
Author(s):  
Andreas Simgen ◽  
Toshiki Tomori ◽  
Hagen Bomberg ◽  
Umut Yilmaz ◽  
Christian Roth ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Good Alternative ◽  
Flow Diverter ◽  
Preclinical Study ◽  
Digital Subtraction ◽  
Intravenous Digital Subtraction Angiography ◽  
Aneurysm Morphology ◽  
Aneurysm Occlusion ◽  
Stent Stenosis

Purpose Conventional intra-arterial digital subtraction angiography, which requires surgical exposure and ligation of the femoral or carotid artery, is a limited method of evaluating elastase-induced aneurysms in New Zealand white rabbits. The purpose of this study was to assess aneurysm morphology, occlusion rates and complications after flow diverter treatment comparing intravenous and intra-arterial digital subtraction angiography. Methods We previously published a preclinical study in which we evaluated the occlusion rates of elastase-induced aneurysms after treatment with a prototype flow diverter, by using intra-arterial digital subtraction angiography at three months ( n = 9) and six months ( n = 9). In addition to that intravenous digital subtraction angiography before treatment, after one month (early follow-up group) and after three months (late follow-up group) was performed. Occlusion rates were compared within the two groups by means of residual contrast filling. Results Baseline aneurysm characteristics revealed no significant differences between intra-arterial digital subtraction angiography and intravenous digital subtraction angiography. Aneurysm occlusion rates in both follow-up groups using intravenous digital subtraction angiography were significantly higher compared to intra-arterial digital subtraction angiography (early follow-up group: intravenous digital subtraction angiography (one month) versus intra-arterial digital subtraction angiography (three months); p = 0.03 and late follow-up group: intravenous digital subtraction angiography (three months) versus intra-arterial digital subtraction angiography (six months); p = 0.04). Intravenous digital subtraction angiography is feasible to detect and reproduce device occlusions, in-stent stenosis and post-stent stenosis. Conclusion Intravenous digital subtraction angiography can not give a sufficient statement on the aneurysm occlusion process compared to intra-arterial digital subtraction angiography and is therefore not recommended for imaging follow-up after flow diverter treatment in rabbits. Regarding untreated aneurysms and complications like device occlusions, in-stent stenosis and post-stent stenosis intravenous digital subtraction angiography proofed to be a good alternative to intra-arterial digital subtraction angiography in our study.

scholarly journals Reliability of dual- vs single-volume reconstruction of three-dimensional digital subtraction angiography for follow-up evaluation of endovascularly treated intracranial aneurysms

2016 ◽  
Vol 22 (6) ◽  
pp. 687-692 ◽  
Author(s):  
Nimer Adeeb ◽  
Christoph J Griessenauer ◽  
Apar S Patel ◽  
Justin Moore ◽  
Parviz Dolati-Ardejani ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Three Dimensional ◽  
Endovascular Embolization ◽  
Digital Subtraction ◽  
Rater Agreement ◽  
Volume Reconstruction ◽  
Rater Reliability

Introduction Single-volume reconstruction of three-dimensional (3D) digital subtraction angiography (DSA) can be effectively used for aneurysm assessment and planning of endovascular embolization. Unfortunately, post-embolization follow-up angiographic images can be obscured by artifact. The dual-volume reconstruction technique was developed in order to reduce artifact and enhance the visualization of the aneurysm, the parent vessel and side branches, and endovascular devices. The purpose of this study was to compare the reliability of dual- vs single-volume reconstruction of 3D DSA in evaluation of follow-up images after endovascular embolization of intracranial aneurysms. Method Four cerebrovascular neurosurgeons independently and blindly reviewed 20 randomly selected dual-and single-volume reconstructions of 3D DSAs demonstrating cerebral aneurysms treated with primary coil embolization, stent-assisted coil embolization, or Pipeline embolization. Five images were repeated for each modality (single and dual volume) in order to assess intra-rater reliability. The intraclass correlation coefficient was calculated as a measure of the overall inter-rater agreement. Cohen’s kappa value was used to assess repeat measurement consistency for each rater. Results Overall inter-rater agreement using dual- and single-volume reconstruction was 0.81 and 0.75, respectively. Dual-volume reconstruction resulted in superior agreement in assessing location, occlusion status, position of aneurysm recanalization or residual, status of nearby branches, presence of coil migration and presence of intravascular devices (stent or Pipeline). Conclusion Three-dimensional reconstruction is an important complementary imaging technique in evaluating the angioarchitecture of aneurysms and recanalization after endovascular embolization. Dual-volume reconstruction imaging was associated with superior inter- and intra-rater reliability.

scholarly journals Proposal of a follow-up imaging strategy following Pipeline flow diversion treatment of intracranial aneurysms

2019 ◽  
Vol 131 (1) ◽  
pp. 32-39 ◽  
Author(s):  
Raghav Gupta ◽  
Christopher S. Ogilvy ◽  
Justin M. Moore ◽  
Christoph J. Griessenauer ◽  
Alejandro Enriquez-Marulanda ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Cumulative Incidence ◽  
Intracranial Aneurysms ◽  
Aneurysm Rupture ◽  
Digital Subtraction ◽  
Imaging Data ◽  
Unruptured Intracranial Aneurysms ◽  
Imaging Strategy ◽  
Aneurysm Occlusion

OBJECTIVEThere is currently no standardized follow-up imaging strategy for intracranial aneurysms treated with the Pipeline embolization device (PED). Here, the authors use follow-up imaging data for aneurysms treated with the PED to propose a standardizable follow-up imaging strategy.METHODSA retrospective review of all patients who underwent treatment for ruptured or unruptured intracranial aneurysms with the PED between March 2013 and March 2017 at 2 major academic institutions in the US was performed.RESULTSA total of 218 patients underwent treatment for 259 aneurysms with the PED and had undergone at least 1 follow-up imaging session to assess aneurysm occlusion status. There were 235 (90.7%) anterior and 24 posterior (9.3%) circulation aneurysms. On Kaplan-Meier analysis, the cumulative incidences of aneurysm occlusion at 6, 12, 18, and 24 months were 38.2%, 77.8%, 84.2%, and 85.1%, respectively. No differences in the cumulative incidence of aneurysm occlusion according to aneurysm location (p = 0.39) or aneurysm size (p = 0.81) were observed. A trend toward a decreased cumulative incidence of aneurysm occlusion in patients 70 years or older was observed (p = 0.088). No instances of aneurysm rupture after PED treatment or aneurysm recurrence after occlusion were noted. Sixteen (6.2%) aneurysms were re-treated with the PED; 11 of these had imaging follow-up data available, demonstrating occlusion in 3 (27.3%).CONCLUSIONSThe authors propose a follow-up imaging strategy that incorporates 12-month digital subtraction angiography and 24-month MRA for patients younger than 70 years and single-session digital subtraction angiography at 12 months in patients 70 years or older. For recurrent or persistent aneurysms, re-treatment with the PED or use of an alternative treatment modality may be considered.

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