3D Road-Mapping in the Endovascular Treatment of Cerebral Aneurysms and Arteriovenous Malformations

Abstract

<jats:p> 3D road-mapping with syngo iPilot was used as an additional tool for assessing cerebral aneurysms and arteriovenous malformations (AVMs) for endovascular therapy. This method provides accurate superimposition of a live fluoroscopic image (native or vascular road-map) and its matching 2D projection of the 3D data set, delivering more anatomic information on one additional display. In the endovascular management of cases with complex anatomy, 3D road-mapping provides excellent image quality at the intervention site. This method can potentially reduce intervention time, the number of DSA runs, fluoroscopy time and the amount of contrast media used in a procedure, with reservation for these factors being mainly operator-dependent. 3D road-mapping probably does not provide any advantage in the treatment of cerebral aneurysms or AVMs with very simple configuration, and it should not be used when acquisition of an optimum 3D data set is not feasible. </jats:p>

Conscious Sedation versus General Anesthesia during Endovascular Acute Ischemic Stroke Treatment: A Systematic Review and Meta-Analysis

“…5 Patients who are awake during endovascular treatment may move during endovascular therapy, which could compromise the safety and efficacy of the intervention. 15 Patient movement during the procedure can lead to wire perforation, resulting in intracranial hemorrhage or vascular injury in the form of dissection. However, no studies have demonstrated that conscious sedation is associated with higher rates of wire perforation, dissection, or intracranial hemorrhage than general anesthesia.…”

Patient radiation exposure during percutaneous endovascular revascularization of the lower extremity

“…33 Additional techniques that may reduce radiation exposure such as preprocedure computed tomographic angiogram mapping overlays and "road-mapping" require further study. 34 Our study has several limitations. It is retrospective and single center.…”

Patient Organ Radiation Doses During Treatment for Aneurysmal Subarachnoid Hemorrhage

“…Endovascular coiling alone, balloonassisted coiling, or stent-assisted coiling was performed as necessary. Imaging during the coiling procedure included 3D rotational angiography in the cases when CTA was not done before, when the CTA study was unsatisfactory for planning the procedure, or for use in 3D road-mapping (iPilot functionality) when demanded by the complexity of the aneurysm [12]. DynaCT was done either before treatment in patients that arrived in general anesthesia and who did not undergo repeated CT or CTA in order to evaluate for re-bleeding or hydrocephalus development during transport from another hospital, or directly after treatment when per-procedural re-bleeding or (based on pericallosal artery and deep cerebral vein topography) huge progress of hydrocephalus was suspected (in this case an external ventriculostomy could be placed immediately).…”