Ultrasound guidance improves secondary outcomes of the common femoral artery puncture when compared to palpation-guided puncture. Technical success and complication rates seem lower in the presence of ultrasound guidance but larger study populations are needed to verify the result.

Single-stage endovascular treatment of multiple aneurysms with combined endovascular techniques is technically feasible and increases the treatment possibility of all detected aneurysms. However, the safety of the procedure is controversial due to relatively high complication rates. In particular, in patients with bilateral internal carotid artery aneurysms, staged therapy may be used instead of simultaneous treatment with flow diverters to avoid thromboembolic events.

We evaluated contrast-enhanced MR angiography (MRA) for the identification of recently ruptured cerebral aneurysms. We studied 23 aneurysms in 18 patients (age range 34-72 years) with aneurysms of the anterior (n = 17) and posterior (n = 6) circulation by comparing 3D time-of-flight (TOF), contrast-enhanced MRA and digital subtraction angiography (DSA). In four of 23 aneurysms, 3D-TOF did not show the lesion. Contrast-enhanced MRA successfully depicted all aneurysms except one. T1 contamination artefacts from subarachnoid or intraparenchymal haemorrhages were evident on the 3D-TOF images in six cases. The artefacts were completely eliminated on the contrast-enhanced MRA images by subtraction of the pre-contrast images. The diagnostic information in patients with subarachnoid haemorrhages (SAHs) provided by contrast-enhanced MRA was comparable to that provided by DSA.

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