Endovascular therapy for selected (most non-surgical) intracranial aneurysms in a Brazilian University Hospital

Abud, Daniel Giansante; Nakiri, Guilherme S.; Abud, Thiago Giansante; Carlotti, Carlos Gilberto; Colli, Benedicto Oscar; Santos, Antônio Carlos dos

doi:10.1590/s0004-282x2010000500017

Cited by 5 publications

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“…At our institution, all patients with cerebral aneurysms treated by embolization undergo angiographic controls by DSA according to the follow-up protocol of 6, 18 and 36 months after embolization;27 therefore, it was not necessary to perform any additional invasive exams for our research. On the day of the scheduled DSA exam, the patient was submitted to an MRI scan as authorized by written informed consent.…”

Section: Methodsmentioning

confidence: 99%

“…All patients were prospectively and consecutively included in the study, following the clinical routine of the interventional neuroradiology service of our institution, from November 2009 until the last patient enrolled in May 2010. At our institution, all patients with cerebral aneurysms treated by embolization undergo angiographic controls by DSA according to the follow-up protocol of 6, 18 and 36 months after embolization; 27 therefore, it was not necessary to perform any additional invasive exams for our research. On the day of the scheduled DSA exam, the patient was submitted to an MRI scan as authorized by written informed consent.…”

Section: Methodsmentioning

confidence: 99%

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A comparison between magnetic resonance angiography at 3 teslas (time-of-flight and contrast-enhanced) and flat-panel digital subtraction angiography in the assessment of embolized brain aneurysms

Nakiri

Santos

Abud

et al. 2011

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PURPOSE:To compare the time-of-flight and contrast-enhanced- magnetic resonance angiography techniques in a 3 Tesla magnetic resonance unit with digital subtraction angiography with the latest flat-panel technology and 3D reconstruction in the evaluation of embolized cerebral aneurysms.INTRODUCTION:Many embolized aneurysms are subject to a recurrence of intra-aneurismal filling. Traditionally, imaging surveillance of coiled aneurysms has consisted of repeated digital subtraction angiography. However, this method has a small but significant risk of neurological complications, and many authors have advocated the use of noninvasive imaging methods for the surveillance of embolized aneurysms.METHODS:Forty-three aneurysms in 30 patients were studied consecutively between November 2009 and May 2010. Two interventional neuroradiologists rated the time-of-flight-magnetic resonance angiography, the contrast-enhanced-magnetic resonance angiography, and finally the digital subtraction angiography, first independently and then in consensus. The status of aneurysm occlusion was assessed according to the Raymond scale, which indicates the level of recanalization according to degrees: Class 1: excluded aneurysm; Class 2: persistence of a residual neck; Class 3: persistence of a residual aneurysm. The agreement among the analyses was assessed by applying the Kappa statistic.RESULTS:Inter-observer agreement was excellent for both methods (K = 0.93; 95 % CI: 0.84-1). Inter-technical agreement was almost perfect between time-of-flight-magnetic resonance angiography and digital subtraction angiography (K = 0.98; 95 % CI: 0.93-1) and between time-of-flight-magnetic resonance angiography and contrast-enhanced-magnetic resonance angiography (K = 0.98; 95% CI: 0.93-1). Disagreement occurred in only one case (2.3%), which was classified as Class I by time-of-flight-magnetic resonance angiography and Class II by digital subtraction angiography. The agreement between contrast-enhanced-magnetic resonance angiography and digital subtraction angiography was perfect (K = 1; 95% CI: 1-1). In three patients, in-stent stenosis was identified by magnetic resonance angiography but not confirmed by digital subtraction angiography.CONCLUSION:Digital subtraction angiography and both 3T magnetic resonance angiography techniques have excellent reproducibility for the assessment of aneurysms embolized exclusively with coils. In those cases also treated with stent remodeling, digital subtraction angiography may still be necessary to confirm eventual parent artery stenosis, as identified by magnetic resonance angiography.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%