3D CT Angiography as a Pre-Embolization Study for Embolization of Cerebral Aneurysms

1997 ◽  
Vol 3 (2_suppl) ◽  
pp. 142-148 ◽  
Author(s):  
K. Fukasaku ◽  
M. Negoro ◽  
M. Bundo ◽  
N. Kourogi ◽  
K. Yamano ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Three Dimensional ◽  
Cerebral Aneurysms ◽  
Parent Artery ◽  
3D Images ◽  
Image Guide ◽  
Laser Lithography ◽  
Real Model ◽  
Aneurysm Embolization ◽  
3D Ct Angiography

An image guide for aneurysm embolization based on three dimensional CT angiography is reported. Multiplanner reformation (MPR) can measure the neck and dome of the aneurysm accurately enough to select the first coils for aneurysms. For neck evaluation, cut model and virtual endoscope are helpful because we can observe the neck from inside of dome or parent artery. Proximal arteries are visualized by 3D images and MPR if needed. Using laser lithography, we can get a real model of aneurysm and parent artery through which we can insert microcatheters and coils. 3D CTA is a dependable modality for embolization of cerebral aneurysms.

Determining the Optimal Fluoroscopic View during Aneurysmal Embolization with Rotation DSA

1997 ◽  
Vol 3 (2_suppl) ◽  
pp. 37-40
Author(s):  
M. Bundo ◽  
M. Negoro ◽  
K. Fukasaku ◽  
S. Miyachi ◽  
J. Yoshida
Keyword(s):  
Endovascular Treatment ◽  
Cerebral Aneurysm ◽  
Ct Angiography ◽  
Three Dimensional ◽  
Parent Artery ◽  
3D Ct ◽  
3D Ct Angiography

To prevent coil protrusion into the parent artery, the fluoroscopic view during coil packing is quite important. However it is not always easy to find out the optimal fluoroscopic view. We applied a rotation DSA to predict the optimal fluoroscopic view for the endovascular treatment of 4 cases with a cerebral aneurysm. Since the trajectory of the C-arm is restricted within 60 degrees only around the patient's head and the number of DSA shots are limited rather than conventional DSA, we employed three dimensional CT angiography (3D-CT angiography) to focus the range of C-arm rotation. Rotation DSA proved quite useful to determine the optimal fluoroscopic view, when combined with pre-estimation by 3D-CT angiography.

Three-dimensional computerized tomography angiography in patients with hyperacute intracerebral hemorrhage

1999 ◽  
Vol 91 (3) ◽  
pp. 424-431 ◽  
Author(s):  
Yasuo Murai ◽  
Ryo Takagi ◽  
Yukio Ikeda ◽  
Yasuhiro Yamamoto ◽  
Akira Teramoto
Keyword(s):  
Intracerebral Hemorrhage ◽  
Ct Angiography ◽  
Computerized Tomography ◽  
Three Dimensional ◽  
Ct Scanning ◽  
3D Ct ◽  
Content Type ◽  
Hematoma Enlargement ◽  
3D Ct Angiography ◽  
Fine Print

Object. The authors confirm the usefulness of extravasation detected on three-dimensional computerized tomography (3D-CT) angiography in the diagnosis of continued hemorrhage and establishment of its cause in patients with acute intracerebral hemorrhage (ICH).Methods. Thirty-one patients with acute ICH in whom noncontrast and 3D-CT angiography had been performed within 12 hours of the onset of hemorrhage and in whom conventional cerebral angiographic studies were obtained during the chronic stage were prospectively studied. Noncontrast CT scanning was repeated within 24 hours of the onset of ICH to evaluate hematoma enlargement.Findings indicating extravasation on 3D-CT angiography, including any abnormal area of high density on helical CT scanning, were observed in five patients; three of these demonstrated hematoma enlargement on follow-up CT studies. Thus, specificity was 60% (three correct predictions among five positives) and sensitivity was 100% (19 correct predictions among 19 negatives). Evidence of extravasation on 3D-CT angiography indicates that there is persistent hemorrhage and correlates with enlargement of the hematoma.Regarding the cause of hemorrhage, five cerebral aneurysms were visualized in four patients, and two diagnoses of moyamoya disease and one of unilateral moyamoya phenomenon were made with the aid of 3D-CT angiography. Emergency surgery was performed without conventional angiography in one patient who had an aneurysm, and it was clipped successfully.Conclusions. Overall, 3D-CT angiography was found to be valuable in the diagnosis of the cause of hemorrhage and in the detection of persistent hemorrhage in patients with acute ICH.

scholarly journals Discrepancy between two-dimensional and three-dimensional digital subtraction angiography for the planning of endovascular coiling of small cerebral aneurysms <5 mm

2020 ◽  
Vol 26 (6) ◽  
pp. 733-740
Author(s):  
Te-Chang Wu ◽  
Yu-Kun Tsui ◽  
Tai-Yuan Chen ◽  
Ching-Chung Ko ◽  
Chien-Jen Lin ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Three Dimensional ◽  
Cerebral Aneurysms ◽  
Endovascular Coiling ◽  
Parent Artery ◽  
Two Dimensional ◽  
Digital Subtraction ◽  
Rotational Angiography ◽  
Treatment Choices ◽  
The Impact

Background To investigate the discrepancy between two-dimensional digital subtraction angiography and three-dimensional rotational angiography for small (<5 mm) cerebral aneurysms and the impact on decision making among neuro-interventional experts as evaluated by online questionnaire. Materials and methods Eight small (<5 mm) ruptured aneurysms were visually identified in 16 image sets in either two-dimensional or three-dimensional format for placement in a questionnaire for 11 invited neuro-interventionalists. For each set, two questions were posed: Question 1: “Which of the following is the preferred treatment choice: simple coiling, balloon remodeling or stent assisted coiling?”; Question 2: “Is it achievable to secure the aneurysm with pure simple coiling?” The discrepancies of angio-architecture parameters and treatment choices between two-dimensional-digital subtraction angiography and three-dimensional rotational angiography were evaluated. Results In all eight cases, the neck images via three-dimensional rotational angiography were larger than two-dimensional-digital subtraction angiography with a mean difference of 0.95 mm. All eight cases analyzed with three-dimensional rotational angiography, but only one case with two-dimensional-digital subtraction angiography were classified as wide-neck aneurysms with dome-to-neck ratio < 1.5. The treatment choices based on the two-dimensional or three-dimensional information were different in 56 of 88 (63.6%) paired answers. Simple coiling was the preferred choice in 66 (75%) and 26 (29.6%) answers based on two-dimensional and three-dimensional information, respectively. Three types of angio-architecture with a narrow gap between the aneurysm sidewall and parent artery were proposed as an explanation for neck overestimation with three-dimensional rotational angiography. Conclusions Aneurysm neck overestimation with three-dimensional rotational angiography predisposed neuro-interventionalists to more complex treatment techniques. Additional two-dimensional information is crucial for endovascular treatment planning for small cerebral aneurysms.

scholarly journals 3D Rotational Angiography: Recent Experience in the Evaluation of Cerebral Aneurysms for Treatment

2000 ◽  
Vol 6 (2) ◽  
pp. 85-94 ◽  
Author(s):  
S. Ishihara ◽  
I.B. Ross ◽  
M. Piotin ◽  
A. Weill ◽  
H. Aerts ◽  
...  
Keyword(s):  
Decision Making ◽  
Surgical Treatment ◽  
Endovascular Treatment ◽  
Three Dimensional ◽  
Cerebral Aneurysms ◽  
Early Experience ◽  
Recent Experience ◽  
Rotational Angiography ◽  
3D Images ◽  
3D Rotational Angiography

Three dimensional (3D) reconstruction techniques providing volume rendered 3D images from rotational angiography data now exist. We report the design and early experience with one such system. 237 aneurysms were studied. Information was obtained on the morphology of the aneurysm itself and the vascular architecture in and around the aneurysm. 218 (92%) aneurysms went on to have endovascular treatment. The 3D images provided valuable information on aneurysmal anatomy, including relationships with the parent and adjacent vessels. This technique allowed fast and safe decision-making regarding the feasibility of endovascular or surgical treatment and provided useful information for performing the chosen treatment.

Multiple aneurysms of the anterior communicating artery: radiological and surgical difficulties

2005 ◽  
Vol 102 (3) ◽  
pp. 495-502 ◽  
Author(s):  
Servet Inci ◽  
Tuncalp Özgen
Keyword(s):  
Ct Angiography ◽  
Correct Diagnosis ◽  
Good Condition ◽  
Three Dimensional ◽  
Anterior Communicating Artery ◽  
Consecutive Series ◽  
Content Type ◽  
Multiple Aneurysms ◽  
3D Ct Angiography ◽  
Fine Print

Object. Multiple aneurysms of the anterior communicating artery (ACoA) occur rarely and have not been well investigated previously. The authors report on a consecutive series of six patients who each harbored multiple ACoA aneurysms. The radiological and surgical difficulties encountered in treating these complex and uncommon aneurysms are described and the pertinent literature is reviewed. Methods. Between October 1996 and August 2003, the authors surgically treated 146 patients with ACoA aneurysms. Six (4.1%) of these patients harbored multiple aneurysms of the ACoA. Four of these patients were men and two were women; their ages ranged from 36 to 72 years. Five patients had two aneurysms and one patient had three. All underwent surgery performed using the pterional approach. The clinical presentations, angiograms, intraoperative difficulties, and surgical results were retrospectively analyzed. All patients had premorbid hypertension. In two cases, the aneurysms were initially misdiagnosed as a single complex aneurysm based on routine cerebral angiograms, but special angiographic views demonstrated double aneurysms. In one case, multiple ACoA aneurysms could be identified using three-dimensional (3D) computerized tomography (CT) angiography. The size of the ACoA aneurysms ranged from 3 to 12 mm (mean 5.3 mm). A total of 13 ACoA aneurysms were successfully occluded in the six patients. Four patients were discharged in good condition, and two patients died. Conclusions. Although multiple ACoA aneurysms are quite rare, the following points should be kept in mind. 1) In bilobular ACoA aneurysms, special angiographic projections and 3D CT angiography or 3D digital subtraction angiography should also be performed to obtain a correct diagnosis. The differentiation of two aneurysms from a bilobular aneurysm during the preoperative period is important for surgical planning. 2) Angiographically, detection of the ruptured aneurysm is often difficult. 3) Resection of the gyrus rectus is necessary to obtain a good operative exposure. 4) Clip selection and sequencing are important. Straight clips with short blades should be preferred to avoid narrowing of the surgeon's view and a collision between the clips.

scholarly journals High-spatial-resolution Three-dimensional CT Angiography for Acute Surgery of Cerebral Aneurysms

2013 ◽  
Vol 41 (2) ◽  
pp. 130-136
Author(s):  
Yoshitsugu OIWA ◽  
Hirotaka OKUMURA ◽  
Yoko HIROHATA ◽  
Ryohei TANAKA ◽  
Hiroo YAMAGA ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Spatial Resolution ◽  
High Spatial Resolution ◽  
Three Dimensional ◽  
Cerebral Aneurysms ◽  
Acute Surgery

scholarly journals The Accuracy and Usefulness of 3D-DSA and 3D-CT Angiography for Cerebral Aneurysms

2001 ◽  
Vol 7 (1_suppl) ◽  
pp. 181-186 ◽  
Author(s):  
F. Ishida ◽  
K. Kawaguchi ◽  
M. Mizuno ◽  
T. Hoshino ◽  
K. Murao ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Three Dimensional ◽  
Cerebral Aneurysms ◽  
Computed Tomographic Angiography ◽  
Dissecting Aneurysm ◽  
Digital Subtraction ◽  
Computed Tomographic ◽  
3D Ct Angiography ◽  
The Difference ◽  
Tomographic Angiography

For evaluation of intracranial cerebral aneurysms, three-dimensional (3D) digital subtraction angiography (DSA) and 3D-computed tomographic angiography (CTA) were demonstrated in fifteen patients. The diagnostic accuracy of preoperative 3DCTA is equal to that of 3D-DSA except for the case with a dissecting aneurysm. The virtual images of 3D-CTA were well correlated with surgical findings. In endovascular treatment of intracranial aneurysms, 3D-DSA had an obvious advantage in obtaining the best working angle of the C-arm. The major branches originating from the dome were depicted on 3D-DSA in two cases that could not be judged on 3D-CTA. The aim of the present study was to verify the difference between 3D-DSA and 3D-CTA for evaluation of intracranial aneurysms.

Microcatheter shaping using three-dimensional printed models for intracranial aneurysm coiling

2019 ◽  
Vol 12 (3) ◽  
pp. 308-310 ◽  
Author(s):  
Y Xu ◽  
W Tian ◽  
Z Wei ◽  
Y Li ◽  
X Gao ◽  
...  
Keyword(s):  
3D Printing ◽  
Three Dimensional ◽  
Target Position ◽  
Artery Aneurysm ◽  
Parent Artery ◽  
Arterial Aneurysm ◽  
Printing Technology ◽  
3D Printing Technology ◽  
Aneurysm Embolization ◽  
Posterior Communicating Artery Aneurysm

Background and purposeMicrocatheterization is an important, but also difficult, technique used for the embolization of intracranial aneurysms. The purpose of this study was to investigate the application of three-dimensional (3D) printing technology in microcatheter shaping.MethodsNine cases of internal carotid artery posterior communicating artery aneurysm diagnosed by CT angiography were selected, and 3D printing technology was used to build a 3D model including the aneurysm and the parent artery. The hollow and translucent model had certain flexibility; it was immersed in water and the microcatheter was introduced into the water to the target position in the aneurysm, followed by heating the water temperature to 50°C. After soaking for 5 min, the microcatheter was taken out and the shaping was completed. After sterilization, the shaped microcatheter was used for arterial aneurysm embolization and evaluation was conducted.ResultsNine cases of microcatheter shaping were satisfactory and shaping the needle was not necessary; no rebound was observed. The microcatheter was placed in an ideal position, and the stent-assisted method was used in three cases of wide-neck aneurysm. There were no complications related to surgery.ConclusionA new microcatheter shaping method using 3D printing technology makes intracranial artery aneurysm embolization more stable and efficient.

scholarly journals Early Experience Studying Cerebral Aneurysms with Rotational and Three-Dimensional Angiography and Review of CT and MR Angiography Literature

2002 ◽  
Vol 8 (4) ◽  
pp. 377-391 ◽  
Author(s):  
C.H. Castaño-Duque ◽  
J. Ruscalleda-Nadal ◽  
M. de Juan-Delago ◽  
E. Guardia-Mas ◽  
L. San Roman-Manzanera ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Three Dimensional ◽  
Cerebral Aneurysms ◽  
Endovascular Embolization ◽  
Lower Sensitivity ◽  
Parent Artery ◽  
Philips Medical System ◽  
Multiple Series ◽  
Total Occlusion ◽  
Aneurysmal Neck

From september 2000 to september 2001, 32 consecutive patients with ruptured intracranial aneurysms were examined with rotational and 3D reconstruction angiography using an Integris V5000 Philips Medical System: 39 aneurysms were detected. After a selective cerebral artery was catheterized with a 5F or 4F-catheter, 35 ml of contrast medium was intra-arterially administered at a rate of 4 ml/s and a 180° rotational angiography was performed in eight seconds. This information was transferred to a computer (Silicon Graphics Octane) with software (Integris 3DRA, Philips Integris Systems) and a three-dimensional reconstruction was made. The information provided by Angio-3D was useful for evaluating the parent artery, aneurysmal sac, aneurysmal neck and arterial branches. It was also very useful in selecting the therapeutic method. For open surgery, this technique provides preoperative images that are useful for planning microsurgical approaches, especially in cases of large aneurysm showing complex surrounding arteries. For endovascular embolization, various anatomic characteristics of the aneurysm such as neck and sac size, shape, lobularity, parent artery and arterial branches adjacent to the aneurysmal neck must be demonstrated. This is very important to determine the best projection for embolization and to avoid multiple series. This is also essential in the choice of the first coil to create a good basket producing total occlusion. Microaneurysms are demonstrated well with this technique whereas this is difficult to do with conventional arteriography. The Angio-RM and Angio-CT literature show a lower sensitivity and specificity in comparasion with our experience with 3D IA-ROT-DSA. For this reason, we believe that 3D IA-ROTDSA is now the gold standard for patients presenting intracranial aneurysms.

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