Takumi Kuriyama1, Nobuyuki Sakai2, Norimitsu Niida3, Masaki Sueoka4, Mikiya Beppu5, Chihebeddine Dahmani6, Iwao Kojima6, Chiaki Sakai7, Hirotoshi Imamura5, Katsuhiro Masago8, Nobuyuki Katakami8. 1. Division of Radiological Technology, Institute of Biomedical Research and Innovation, Kobe, Japan kuriyama@fbri.org. 2. Division of Neuroendovascular Therapy, Institute of Biomedical Research and Innovation, Kobe, Japan Division of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan. 3. CA/IR Department, Division of Advanced Therapies, Siemens Japan, Tokyo, Japan. 4. Division of Radiological Technology, Institute of Biomedical Research and Innovation, Kobe, Japan. 5. Division of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan. 6. Research and Collaboration Department, Siemens Japan, Tokyo, Japan. 7. Division of Neuroendovascular Therapy, Institute of Biomedical Research and Innovation, Kobe, Japan. 8. Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe, Japan.
Abstract
PURPOSE: Flat panel detector (FD)-equipped angiography machines are increasingly used for neuro-angiographic imaging. During intracranial stent-assisted coil embolization procedures, it is very important to clearly and quickly visualize stent shape after deployment in the vessel. It is necessary to quickly visualize stents by cone-beam computed tomography (CBCT). The aim of this study was to compare CBCTs at 10 and 20 s, and to confirm that this method is useful for neuro-endovascular treatment procedures. MATERIALS AND METHODS: We treated 30 patients with wide-necked intracranial aneurysms with a flexible, self-expanding neurovascular stent and subsequent aneurysm embolization with platinum micro-coils. We performed the CBCT after stent deployment. We compared the 10 s and 20 s CBCTs, using the full width one-half maximum (FWHM) visualization. RESULTS: Accurate stent placement with subsequent coil occlusion of the aneurysms was feasible in all patients. Stent struts were clearly visualized on both 10 s and 20 s CBCTs. Importantly, 10 s CBCT can reduce the radiation dose by about 42%, compared with 20 s CBCT. Performing 10 s CBCT with a 14% dilution of the contrast medium may significantly improve image acquisition during stent-assisted coil embolization. CONCLUSIONS: Reduced-dose, 10 s CBCT can visualize stents in clinical cases, while significantly reducing radiation exposure.
PURPOSE: Flat panel detector (FD)-equipped angiography machines are increasingly used for neuro-angiographic imaging. During intracranial stent-assisted coil embolization procedures, it is very important to clearly and quickly visualize stent shape after deployment in the vessel. It is necessary to quickly visualize stents by cone-beam computed tomography (CBCT). The aim of this study was to compare CBCTs at 10 and 20 s, and to confirm that this method is useful for neuro-endovascular treatment procedures. MATERIALS AND METHODS: We treated 30 patients with wide-necked intracranial aneurysms with a flexible, self-expanding neurovascular stent and subsequent aneurysm embolization with platinum micro-coils. We performed the CBCT after stent deployment. We compared the 10 s and 20 s CBCTs, using the full width one-half maximum (FWHM) visualization. RESULTS: Accurate stent placement with subsequent coil occlusion of the aneurysms was feasible in all patients. Stent struts were clearly visualized on both 10 s and 20 s CBCTs. Importantly, 10 s CBCT can reduce the radiation dose by about 42%, compared with 20 s CBCT. Performing 10 s CBCT with a 14% dilution of the contrast medium may significantly improve image acquisition during stent-assisted coil embolization. CONCLUSIONS: Reduced-dose, 10 s CBCT can visualize stents in clinical cases, while significantly reducing radiation exposure.
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