Single-center experience of using high definition (Hi-Def) imaging during neurointervention treatment of intracranial aneurysms using flow diverters

Nagesh, Swetadri Vasan Setlur; Vakharia, Kunal; Waqas, Muhammad; Munich, Stephan A; Bednarek, Daniel R.; Davies, Jason M; Snyder, Kenneth V.; Mokin, Maxim; Rudin, Stephen; Levy, Elad I.; Siddiqui, Adnan H.

doi:10.1136/neurintsurg-2019-015551

Cited by 4 publications

(1 citation statement)

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“…4 The high resolution images are acquired using the 75-µm high spatial resolution Hi-Def mode of a novel dual resolution detector system by Canon Medical Systems Corporation. 5 Images acquired at such low frame rates do not have the necessary temporal resolution to accurately capture the patterns present in blood flow, such as streamlines and vortices. This can be evidenced in Figure 1, comparing the DSA images prior to (Figure 1.1) and after deployment of the stent (Figure 1.2); it can be erroneously concluded that the treatment failed or succeeded.…”

Section: Introductionmentioning

confidence: 99%

Comparison of pulsatile flow dynamics before and after endovascular intervention in 3D-printed patient-specific internal carotid artery aneurysm models using 1000 fps photon-counting detectors for Simultaneous Biplane High Speed Angiography (SB-HSA)

Vanderbilt

Nagesh

et al. 2023

Medical Imaging 2023: Biomedical Applications in Molecular, Structural, and Functional Imaging

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A significant challenge regarding the treatment of aneurysms is the variability in morphology and analysis of abnormal flow. With conventional DSA, low frame rates limit the flow information available to clinicians at the time of the vascular intervention. With 1000 fps High-Speed Angiography (HSA), high frame rates enable flow details to be better resolved for endovascular interventional guidance. The purpose of this work is to demonstrate how 1000 fps biplane-HSA can be used to differentiate flow features, such as vortex formation and endoleaks, amongst patient-specific internal carotid artery aneurysm phantoms pre-and post-endovascular intervention using an in-vitro flow setup. The aneurysm phantoms were attached to a flow loop configured to a carotid waveform, with automated injections of contrast media. Simultaneous Biplane High-Speed Angiographic (SB-HSA) acquisitions were obtained at 1000 fps using two photon-counting detectors with the respective aneurysm and inflow/ outflow vasculature in the FOV. After x-rays were turned on, the detector acquisitions occurred simultaneously, during which iodine contrast was injected at a continuous rate. A pipeline stent was then deployed to divert flow from the aneurysm, and image sequences were once again acquired using the same parameters. Optical Flow, an algorithm that calculates velocity based on spatial-temporal intensity changes between pixels, was used to derive velocity distributions from HSA image sequences. Both the image sequences and velocity distributions indicate detailed changes in flow features amongst the aneurysms before and after deployment of the interventional device. SB-HSA can provide detailed flow analysis, including streamline and velocity changes, which may be beneficial for interventional guidance.

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Section: Introductionmentioning

confidence: 99%