Adjunctive value of intra-arterial cone beam CT angiography relative to DSA in the evaluation of cranial and spinal arteriovenous fistulas

Honarmand, A; Gemmete, Joseph J.; Hurley, Michael C.; Shaibani, Ali; Chaudhary, Neeraj; Pandey, Aditya S.; Bendok, Bernard R.; Ansari, Sameer A.

doi:10.1136/neurintsurg-2014-011139

Cited by 14 publications

(8 citation statements)

References 28 publications

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“…Without additional contrast media or radiation exposure, IA-CBCTA can be reconstructed from a routine 3DRA. As an adjunct to the traditional angiograms, this tool has been shown to increase the diagnostic power to detect intracranial microarteriovenous malformation of arteriovenous fistula [ 3 , 4 ]. It is also helpful in treatment planning because of its superb ability in cross-sectional localization [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Adjunctive efficacy of intra-arterial cone-beam computed tomography angiography in the endovascular treatment of vertebra–venous fistula

Wen¹,

Yang

et al. 2021

Journal of Surgical Case Reports

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Vertebro–venous fistula (VVF) refers to an abnormal arteriovenous shunt connecting the extracranial vertebral artery and the paraspinal venous structures. Coil embolization is the mainstay treatment of choice for VVF, and accurate definition of the endovascular target is mandatory. Traditionally, catheter-based angiograms are used for treatment planning, but those images lack bony information to delineate the precise relationship of the drainage veins to the spinal structure. Herein, we presented two VVF cases and demonstrated how we used intra-arterial cone-beam computed tomography angiography (IA-CBCTA) to determine the safe embolization zone for dense coil packing. We propose that IA-CBCTA is a useful adjunct in the endovascular planning of VVF by offering an image consisting of bony and vascular information.

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Section: Discussionmentioning

confidence: 99%

Adjunctive efficacy of intra-arterial cone-beam computed tomography angiography in the endovascular treatment of vertebra–venous fistula

Wen¹,

Yang

et al. 2021

Journal of Surgical Case Reports

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“…treatment planning. 8,9,18 Flat panel detectors improve the signal intensity-to-noise ratio and suppress geometric distortion, enabling 3DRA and IA-CBCTA to produce high spatial and contrast-resolution imaging with radiation and contrast-dose reduction. 19 Isotropic CBCT volumetric datasets allow multiplanar and 3D reconstructions analogous to multidetector CT scanners.…”

Section: Discussionmentioning

confidence: 99%

“…7 Prior studies have described the efficacy of IA-CBCTA for the anatomic localization of intracranial and spinal dural AVFs. 8,9 In this study, we hypothesized that the efficacy of IA-CBCTA relative to DSA would improve the diagnostic identification, localization, and treatment planning of mAVMs.…”

mentioning

confidence: 99%

Adjunctive Efficacy of Intra-Arterial Conebeam CT Angiography Relative to DSA in the Diagnosis and Surgical Planning of Micro-Arteriovenous Malformations

Al-Smadi¹,

Elmokadem²,

Shaibani

et al. 2018

AJNR Am J Neuroradiol

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“…Planning cerebrovascular malformation embolization is challenging because it requires a detailed understanding of both the malformation supplying vasculature anatomy and the arterio-venous flow dynamics (Tranvinh et al 2017 ). Cone beam CT (CBCT) is a key modality to overcome the intrinsic limitation of the 2-dimensional (2D) projective nature of DSA and enhances 3D visualization of the anatomy (Doerfler et al 2015 ; Honarmand et al 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Simulation of superselective catheterization for cerebrovascular lesions using a virtual injection software

Sundararajan

Ranganathan

Kishore³

et al. 2021

CVIR Endovasc

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Background This report addresses the feasibility of virtual injection software based on contrast-enhanced cone-beam CTs (CBCTs) in the context of cerebrovascular lesion embolization. Intracranial arteriovenous malformation (AVM), dural arteriovenous fistula (AVF) and mycotic aneurysm embolization cases with CBCTs performed between 2013 and 2020 were retrospectively reviewed. Cerebrovascular lesions were reviewed by 2 neurointerventionalists using a dedicated virtual injection software (EmboASSIST, GE Healthcare; Chicago, IL). Points of Interest (POIs) surrounding the vascular lesions were first identified. The software then automatically displayed POI-associated vascular traces from vessel roots to selected POIs. Vascular segments and reason for POI identification were recorded. Using 2D multiplanar reconstructions from CBCTs, the accuracy of vascular traces was assessed. Clinical utility metrics were recorded on a 3-point Likert scale from 1 (no benefit) to 3 (very beneficial). Results Nine cases (7 AVM, 1 AVF, 1 mycotic aneurysm) were reviewed, with 26 POIs selected. Three POIs were in 2nd order segments, 8 POIs in 3rd order segments and 15 POIs in 4th order segments of their respective arteries. The reviewers rated all 26 POI traces – involving a total of 90 vascular segments – as accurate. The average utility score across the 8 questions were 2.7 and 2.8 respectively from each reviewer, acknowledging the software’s potential benefit in cerebrovascular embolization procedural planning. Conclusion The operators considered CBCT-based virtual injection software clinically useful and accurate in guiding and planning cerebrovascular lesion embolization in this retrospective review. Future prospective studies in larger cohorts are warranted for validation of this modality.

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Adjunctive value of intra-arterial cone beam CT angiography relative to DSA in the evaluation of cranial and spinal arteriovenous fistulas

Abstract: IA-CBCTA as an adjunctive technique to DSA improves the anatomic delineation of AVFs, particularly for the fistula site and cross-sectional localization, and has the potential to improve treatment planning.

Cited by 14 publications

References 28 publications

Adjunctive efficacy of intra-arterial cone-beam computed tomography angiography in the endovascular treatment of vertebra–venous fistula

Adjunctive efficacy of intra-arterial cone-beam computed tomography angiography in the endovascular treatment of vertebra–venous fistula

Adjunctive Efficacy of Intra-Arterial Conebeam CT Angiography Relative to DSA in the Diagnosis and Surgical Planning of Micro-Arteriovenous Malformations

Simulation of superselective catheterization for cerebrovascular lesions using a virtual injection software

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