Swetadri Vasan Setlur Nagesh1,2, Kunal Vakharia2,3, Muhammad Waqas2,3, Vernard S Fennell2,3, Gursant S Atwal2,3, Hussain Shallwani2,3, Daniel R Bednarek1,2,4, Jason M Davies1,2,3,5,6, Kenneth V Snyder1,2,3,7, Maxim Mokin8, Stephen Rudin1,2,4,9,10,11, Elad I Levy1,2,3,4, Adnan H Siddiqui1,2,3,4,6. 1. Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY. 2. Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY. 3. Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY. 4. Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY. 5. Department of Bioinformatics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY. 6. Jacobs Institute, Buffalo, NY. 7. Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY. 8. Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL. 9. Department of Biomedical Engineering, University at Buffalo, Buffalo, NY. 10. Department of Mechanical and Aerospace Engineering, University at Buffalo, Buffalo, NY. 11. Department of Electrical Engineering, University at Buffalo, Buffalo, NY.
Abstract
BACKGROUND AND PURPOSE: Visualization of structural details of treatment devices during neurointerventional procedures can be challenging. A new true two-resolution imaging X-ray detector system features a 194 µm pixel conventional flat-panel detector (FPD) mode and a 76 µm pixel high-resolution high-definition (Hi-Def) zoom mode in one detector panel. The Hi-Def zoom mode was developed for use in interventional procedures requiring superior image quality over a small field of view (FOV). We report successful use of this imaging system during intracranial aneurysm treatment in 1 patient with a Pipeline-embolization device and 1 patient with a low-profile visualized intramural support (LVIS Blue) device plus adjunctive coiling. METHODS: A guide catheter was advanced from the femoral artery insertion site to the proximity of each lesion using standard FPD mode. Under magnified small FOV Hi-Def imaging mode, an intermediate catheter and microcatheters were guided to the treatment site, and the PED and LVIS Blue plus coils were deployed. Radiation doses were tracked intraprocedurally. RESULTS: Critical details, including structural changes in the PED and LVIS Blue and position and movement of the microcatheter tip within the coil mass, were more readily apparent in Hi-Def mode. Skin-dose mapping indicated that Hi-Def mode limited radiation exposure to the smaller FOV of the treatment area. CONCLUSIONS: Visualization of device structures was much improved in the high-resolution Hi-Def mode, leading to easier, more controlled deployment of stents and coils than conventional FPD mode.
BACKGROUND AND PURPOSE: Visualization of structural details of treatment devices during neurointerventional procedures can be challenging. A new true two-resolution imaging X-ray detector system features a 194 µm pixel conventional flat-panel detector (FPD) mode and a 76 µm pixel high-resolution high-definition (Hi-Def) zoom mode in one detector panel. The Hi-Def zoom mode was developed for use in interventional procedures requiring superior image quality over a small field of view (FOV). We report successful use of this imaging system during intracranial aneurysm treatment in 1 patient with a Pipeline-embolization device and 1 patient with a low-profile visualized intramural support (LVIS Blue) device plus adjunctive coiling. METHODS: A guide catheter was advanced from the femoral artery insertion site to the proximity of each lesion using standard FPD mode. Under magnified small FOV Hi-Def imaging mode, an intermediate catheter and microcatheters were guided to the treatment site, and the PED and LVIS Blue plus coils were deployed. Radiation doses were tracked intraprocedurally. RESULTS: Critical details, including structural changes in the PED and LVIS Blue and position and movement of the microcatheter tip within the coil mass, were more readily apparent in Hi-Def mode. Skin-dose mapping indicated that Hi-Def mode limited radiation exposure to the smaller FOV of the treatment area. CONCLUSIONS: Visualization of device structures was much improved in the high-resolution Hi-Def mode, leading to easier, more controlled deployment of stents and coils than conventional FPD mode.
Authors: Peter Kan; Parham Yashar; Ciprian N Ionita; Amit Jain; Stephen Rudin; Elad I Levy; Adnan H Siddiqui Journal: J Neurointerv Surg Date: 2012-01-21 Impact factor: 5.836
Authors: Mandy J Binning; David Orion; Parham Yashar; Sharon Webb; Ciprian N Ionita; Amit Jain; Stephen Rudin; L Nelson Hopkins; Adnan H Siddiqui; Elad I Levy Journal: Neurosurgery Date: 2011-11 Impact factor: 4.654
Authors: Matthew J Koch; Christopher J Stapleton; Scott B Raymond; Susan Williams; Thabele M Leslie-Mazwi; James David Rabinov; Aman B Patel Journal: J Neurointerv Surg Date: 2018-01-13 Impact factor: 5.836
Authors: S V Setlur Nagesh; V Fennel; J Krebs; C Ionita; J Davies; D R Bednarek; M Mokin; A H Siddiqui; S Rudin Journal: AJNR Am J Neuroradiol Date: 2018-12-27 Impact factor: 3.825