BACKGROUND AND PURPOSE: Important findings, such as aneurysm remnants or major arterial occlusion, can be detected on intra- or postoperative angiography after surgical clipping of intracranial aneurysms. The purpose of this study was to evaluate the feasibility of IV-ACT for the postoperative detection of residual aneurysms and parent vessel patency compared with IA-DSA, which was selected as the standard reference method. MATERIALS AND METHODS: Twenty-two patients with 27 aneurysms treated by surgical clipping were examined by using both IA-DSA and IV-ACT. Both diagnostic procedures were performed on an FPD-equipped angiography system. Postprocessing of IV-ACT acquisitions was performed on a dedicated workstation producing multiplanar reformations and maximum intensity projections of the clip region and other intracranial arteries. Three interventional neuroradiologists independently evaluated both procedures. RESULTS: A residual aneurysm was delineated in 10 cases with IA-DSA. Sufficient opacification of the intracranial vessels was assigned in 26 IV-ACT cases. Due to metal artifacts, IV-ACT images were tagged as "not diagnostic" on 8 occasions. In the other 19 aneurysms, a residual aneurysm was delineated in 6 cases-all 6 being true-positive compared with IA-DSA-and was excluded in the remaining 13 cases-all true-negative. Even small aneurysm remnants with a diameter of 1.5 mm were detected with IV-ACT. CONCLUSIONS: Currently IV-ACT cannot be recommended as a routine tool for postoperative evaluation of clipped aneurysms due to metal artifacts in 30% of the examinations. These artifacts appear with multiple normal-sized or large clips. In patients with single or multiple small clips, IV-ACT can reliably show aneurysm remnants.
BACKGROUND AND PURPOSE: Important findings, such as aneurysm remnants or major arterial occlusion, can be detected on intra- or postoperative angiography after surgical clipping of intracranial aneurysms. The purpose of this study was to evaluate the feasibility of IV-ACT for the postoperative detection of residual aneurysms and parent vessel patency compared with IA-DSA, which was selected as the standard reference method. MATERIALS AND METHODS: Twenty-two patients with 27 aneurysms treated by surgical clipping were examined by using both IA-DSA and IV-ACT. Both diagnostic procedures were performed on an FPD-equipped angiography system. Postprocessing of IV-ACT acquisitions was performed on a dedicated workstation producing multiplanar reformations and maximum intensity projections of the clip region and other intracranial arteries. Three interventional neuroradiologists independently evaluated both procedures. RESULTS: A residual aneurysm was delineated in 10 cases with IA-DSA. Sufficient opacification of the intracranial vessels was assigned in 26 IV-ACT cases. Due to metal artifacts, IV-ACT images were tagged as "not diagnostic" on 8 occasions. In the other 19 aneurysms, a residual aneurysm was delineated in 6 cases-all 6 being true-positive compared with IA-DSA-and was excluded in the remaining 13 cases-all true-negative. Even small aneurysm remnants with a diameter of 1.5 mm were detected with IV-ACT. CONCLUSIONS: Currently IV-ACT cannot be recommended as a routine tool for postoperative evaluation of clipped aneurysms due to metal artifacts in 30% of the examinations. These artifacts appear with multiple normal-sized or large clips. In patients with single or multiple small clips, IV-ACT can reliably show aneurysm remnants.
Authors: M-N Psychogios; P Schramm; J-H Buhk; A Xyda; K Gröschel; K Jung; M Knauth Journal: AJNR Am J Neuroradiol Date: 2010-07-15 Impact factor: 3.825
Authors: Jeffrey D Klopfenstein; Robert F Spetzler; Louis J Kim; Iman Feiz-Erfan; Patrick P Han; Joseph M Zabramski; Randall W Porter; Felipe C Albuquerque; Cameron G McDougall; David J Fiorella Journal: J Neurosurg Date: 2004-02 Impact factor: 5.115
Authors: Max Wintermark; Antoine Uske; Marc Chalaron; Luca Regli; Philippe Maeder; Reto Meuli; Pierre Schnyder; Stefano Binaghi Journal: J Neurosurg Date: 2003-04 Impact factor: 5.115
Authors: Marios-Nikos Psychogios; Bernhard Scholz; Christopher Rohkohl; Yiannis Kyriakou; Alexander Mohr; Peter Schramm; Dorothee Wachter; Katrin Wasser; Michael Knauth Journal: Neuroradiology Date: 2013-04-16 Impact factor: 2.804