Correlation Between Contrast Time–Density Time on Digital Subtraction Angiography and Flow: An in Vitro Study

Brunozzi, Denise; Ismail, Rahim; Linninger, Andreas A.; Hsu, Chih Yang; Charbel, Fady T.

doi:10.1016/j.wneu.2017.10.178

Cited by 3 publications

(3 citation statements)

References 30 publications

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“…They found that incomplete occlusion in the presence of an FDS is associated with higher aneurysmal flow activity. 21 This result suggests that faster intra-aneurysmal flow is associated with lower rates of aneurysm occlusion 22 providing support to our findings. After stent deployment in our cohort, aneurysms with complete occlusion at six months' follow-up showed significant absolute and relative increase in the 2D parametric AUC ratio, namely reduced aneurysmal contrast time-density curve in the aneurysm sac compared to baseline pre-FDS.…”

Section: Discussionsupporting

confidence: 85%

2D parametric contrast time-density analysis for the prediction of complete aneurysm occlusion at six months’ post-flow diversion stent

et al. 2020

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Objective Indications for the treatment of cerebral aneurysms with flow diversion stents are expanding. The current aneurysm occlusion rate at six months ranges between 60 and 80%. Predictability of complete vs. partial aneurysm occlusion is poorly defined. Here, we evaluate the angiographic contrast time-density as a predictor of aneurysm occlusion rate at six months’ post-flow diversion stents. Methods Patients with unruptured cerebral aneurysms proximal to the internal carotid artery terminus treated with single flow diversion stents were included. 2D parametric parenchymal blood flow software (Siemens-Healthineers, Forchheim, Germany) was used to calculate contrast time-density within the aneurysm and in the proximal adjacent internal carotid artery. The area under the curve ratio between the two regions of interests was assessed at baseline and after flow diversion stents deployment. The area under the curve ratio between completely vs. partially occluded aneurysms at six months’ follow-up was compared. Results Thirty patients with 31 aneurysms were included. Mean aneurysm diameter was 8 mm (range 2–28 mm). Complete occlusion was obtained in 19 aneurysms. Younger patients ( P = 0.006) and smaller aneurysms ( P = 0.046) presented higher chance of complete obliteration. Incomplete occlusion of the aneurysm was more likely if the area under the curve contrast time-density ratio showed absolute ( P = 0.001) and relative percentage ( P = 0.001) decrease after flow diversion stents deployment. Area under ROC curve was 0.85. Conclusion Negative change in the area under the curve ratio indicates less contrast stagnation in the aneurysm and lower chance of occlusion. These data provide a real-time analysis after aneurysm treatment. If validated in larger datasets, this can prompt input to the surgeon to place a second flow diversion stents.

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Section: Discussionsupporting

confidence: 85%

2D parametric contrast time-density analysis for the prediction of complete aneurysm occlusion at six months’ post-flow diversion stent

et al. 2020

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“…25,26,27 In a previous study, we demonstrated a statistically significant relationship between intranidal maximum vein wall thickness and total AVM flow, AVM flow through each draining vein, and mean intranidal vessel diameter. 28,29 This study was the first to link high AVM flow to venous intimal hyperplasia and venous outflow stenosis, suggesting that there is a relationship between the abnormal hemodynamic features found in AVMs and the development of stenosis. 28,29,30 In another recently published study, we demonstrated a statistically significant association between age and the prevalence of AVM venous outflow stenosis.…”

Section: Hypothesismentioning

confidence: 85%

“…28,29 This study was the first to link high AVM flow to venous intimal hyperplasia and venous outflow stenosis, suggesting that there is a relationship between the abnormal hemodynamic features found in AVMs and the development of stenosis. 28,29,30 In another recently published study, we demonstrated a statistically significant association between age and the prevalence of AVM venous outflow stenosis. 31 Venous stenosis was present in a significantly higher proportion of patients ≥50 years versus patients <50 years of age (P = 0.03).…”

Section: Hypothesismentioning

confidence: 85%

Cerebral arteriovenous malformation venous stenosis is associated with hemodynamic changes at the draining vein-venous sinus junction

et al. 2019

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Cerebral arteriovenous malformations (AVMs) are an uncommon vascular anomaly that carry the risk of rupture and hemorrhage. Several factors have been implicated in the propensity of an AVM to bleed. One such factor is stenosis of AVM draining veins, as impairment of the AVM venous drainage system is associated with increased risk of intracranial hemorrhage. Currently, our understanding of the pathogenesis of AVM venous outf low stenosis is limited, as there is insufficient data on the blood flow patterns and local hemodynamic parameters of these draining veins.The angioarchitecture of AVMs features a nidus lacking a high resistance capillary network. Accordingly, our previous studies on AVM arterial feeders have demonstrated an abnormally high flow volume rate along with low pulsatility and resistance indices on quantitative magnetic resonance angiography. As such, AVM vessels endure high, non-physiologic levels of flow that may partially contribute to ectasia or stenosis depending on whether wall shear stress (WSS) is high or low, respectively.We hypothesize that AVM venous outflow stenosis occurs most commonly near the junction of the draining vein and the dural venous sinus. Increased flow volume rate through the AVM circuit coupled with the variation in compliance and rigidity between the walls of the draining vein and the dural venous sinus likely create turbulence of blood flow. The resulting flow separation, low WSS, and departure from axially aligned, unidirectional flow may create atherogenic conditions that can be implicated in venous intimal hyperplasia and outflow stenosis. We have previously found there to be a significant association between intimal hyperplagia risk factors and venous

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Blood-Flow Estimation in the Hepatic Arteries Based on 3D/2D Angiography Registration

Lessard¹,

Plantefève

Michaud³

et al. 2018

Intravascular Imaging and Computer Assisted Stenting and Large-Scale Annotation of Biomedical Data and Expert Label Synthesis

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Correlation Between Contrast Time–Density Time on Digital Subtraction Angiography and Flow: An in Vitro Study

Cited by 3 publications

References 30 publications

2D parametric contrast time-density analysis for the prediction of complete aneurysm occlusion at six months’ post-flow diversion stent

2D parametric contrast time-density analysis for the prediction of complete aneurysm occlusion at six months’ post-flow diversion stent

Cerebral arteriovenous malformation venous stenosis is associated with hemodynamic changes at the draining vein-venous sinus junction

Blood-Flow Estimation in the Hepatic Arteries Based on 3D/2D Angiography Registration

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