Tolga Turan Dundar1, Ayse Aralasmak2, Serkan Kitiş3, Fatih Temel Yılmaz2, Anas Abdallah3. 1. Department of Neurosurgery, Faculty of Medicine, Bezmi Alem University, İstanbul, Turkey. Electronic address: tdundar@bezmialem.edu.tr. 2. Department Radiology, Faculty of Medicine, Bezmi Alem University, İstanbul, Turkey. 3. Department of Neurosurgery, Faculty of Medicine, Bezmi Alem University, İstanbul, Turkey.
Abstract
BACKGROUND: Assessing clipped intracranial aneurysms for residues or incomplete occlusions is critical. Digital subtraction angiography (DSA) has been the gold standard for this. Previously, we presented subtracted computed tomography angiography (sub-CTA) from computed tomography perfusion as a more effective noninvasive technique for clipped aneurysms. The aim of this study was to compare effectiveness of sub-CTA with DSA in residue evaluation. METHODS: A retrospective study of 17 patients with aneurysmal subarachnoid hemorrhage operated on at our institution between November 1, 2016, and December 31, 2018, was performed. Residue aneurysms were evaluated with both sub-CTA and DSA. Positive predictive value and negative predictive value were calculated. Correlation between techniques was determined by the McNemar test and κ value. RESULTS: Sensitivity of sub-CTA in residue evaluation was low in aneurysms ≤3 mm (positive predictive value = 60%). DSA detected residue aneurysm in 29% (5/17) of patients, whereas sub-CTA detected residue aneurysm in 11% (2/17). Only 40% of aneurysms (2/5) were demonstrated by sub-CTA, all >3 mm; 60% (3/5) were missed, all ≤3 mm. CONCLUSIONS: This is the first study comparing the effectiveness of sub-CTA from computed tomography perfusion with DSA in residue aneurysm evaluation. Our results were suggestive, but not conclusive. DSA is still the gold standard in residue evaluation. Sub-CTA from computed tomography perfusion can be a reliable method in evaluation of residual aneurysm >3 mm.
BACKGROUND: Assessing clipped intracranial aneurysms for residues or incomplete occlusions is critical. Digital subtraction angiography (DSA) has been the gold standard for this. Previously, we presented subtracted computed tomography angiography (sub-CTA) from computed tomography perfusion as a more effective noninvasive technique for clipped aneurysms. The aim of this study was to compare effectiveness of sub-CTA with DSA in residue evaluation. METHODS: A retrospective study of 17 patients with aneurysmal subarachnoid hemorrhage operated on at our institution between November 1, 2016, and December 31, 2018, was performed. Residue aneurysms were evaluated with both sub-CTA and DSA. Positive predictive value and negative predictive value were calculated. Correlation between techniques was determined by the McNemar test and κ value. RESULTS: Sensitivity of sub-CTA in residue evaluation was low in aneurysms ≤3 mm (positive predictive value = 60%). DSA detected residue aneurysm in 29% (5/17) of patients, whereas sub-CTA detected residue aneurysm in 11% (2/17). Only 40% of aneurysms (2/5) were demonstrated by sub-CTA, all >3 mm; 60% (3/5) were missed, all ≤3 mm. CONCLUSIONS: This is the first study comparing the effectiveness of sub-CTA from computed tomography perfusion with DSA in residue aneurysm evaluation. Our results were suggestive, but not conclusive. DSA is still the gold standard in residue evaluation. Sub-CTA from computed tomography perfusion can be a reliable method in evaluation of residual aneurysm >3 mm.
Authors: Tolga Turan Dundar; Ismail Yurtsever; Meltem Kurt Pehlivanoglu; Ugur Yildiz; Aysegul Eker; Mehmet Ali Demir; Ahmet Serdar Mutluer; Recep Tektaş; Mevlude Sila Kazan; Serkan Kitis; Abdulkerim Gokoglu; Ihsan Dogan; Nevcihan Duru Journal: Front Surg Date: 2022-04-29
Authors: Guilherme Brasileiro de Aguiar; Matheus Kohama Kormanski; Carolina Junqueira Tavares Corrêa; Andrew Vinícius de Souza Batista; Mario Luiz Marques Conti; José Carlos Esteves Veiga Journal: Clinics (Sao Paulo) Date: 2020-10-26 Impact factor: 2.365