Grace M Y Ma1, Adam A Dmytriw2,3, Premal A Patel4,5, Nicholas Shkumat2, Timo Krings3, Manohar M Shroff2, Prakash Muthusami2. 1. Image Guided Therapy, Department of Diagnostic Imaging, Department of Medical Imaging, Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON, M5S, Canada. gracemy.ma@gmail.com. 2. Image Guided Therapy, Department of Diagnostic Imaging, Department of Medical Imaging, Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON, M5S, Canada. 3. Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada. 4. Wellcome / EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, Bloomsbury, London, WC1E 6BT, UK. 5. Radiology Department, Great Ormond Street Hospital for Children, London, UK.
Abstract
BACKGROUND: Several complex pediatric neurovascular conditions are amenable to endovascular treatment. Given the unique anatomical and physiological challenges in children, there is an ongoing need for tools and techniques that provide accurate information for treatment planning, while minimizing exposure to ionizing radiation and contrast. This is more so for neonates and infants with high-flow arteriovenous (AV) shunts that are challenging to assess using conventional techniques. OBJECTIVE: In this brief report, we describe, through representative cases, the potential role of quantitative color-coded digital subtraction angiography (qDSA) in neuroendovascular procedures in children with high-flow AV shunting lesions. METHODS: Images were obtained using an ArtisQ biplane system (Siemens Healthineers, Erlangen, Germany). Post-processing was performed at a dedicated workstation (Syngo, Siemens) using the iFlow module to generate color-coded maps of individual digital subtraction angiography runs. CONCLUSION: Color-coded qDSA provides real-time quantitative information in high-flow AV shunting neurovascular lesions. This can potentially help direct treatment choices, optimize endovascular treatment protocols, monitor outcomes, and determine treatment end points.
BACKGROUND: Several complex pediatric neurovascular conditions are amenable to endovascular treatment. Given the unique anatomical and physiological challenges in children, there is an ongoing need for tools and techniques that provide accurate information for treatment planning, while minimizing exposure to ionizing radiation and contrast. This is more so for neonates and infants with high-flow arteriovenous (AV) shunts that are challenging to assess using conventional techniques. OBJECTIVE: In this brief report, we describe, through representative cases, the potential role of quantitative color-coded digital subtraction angiography (qDSA) in neuroendovascular procedures in children with high-flow AV shunting lesions. METHODS: Images were obtained using an ArtisQ biplane system (Siemens Healthineers, Erlangen, Germany). Post-processing was performed at a dedicated workstation (Syngo, Siemens) using the iFlow module to generate color-coded maps of individual digital subtraction angiography runs. CONCLUSION: Color-coded qDSA provides real-time quantitative information in high-flow AV shunting neurovascular lesions. This can potentially help direct treatment choices, optimize endovascular treatment protocols, monitor outcomes, and determine treatment end points.
Entities:
Keywords:
Arteriovenous; Children; Digital subtraction angiography; Quantitative; iFlow
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