Utility of VasoCT in the treatment of intracranial aneurysm with flow-diverter stents

Clinical article

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  • 1 Department of Radiology, Division of Neuroradiology, Cerrahpasa Medical School, University of Istanbul, Kocamustafapasa, Istanbul, Turkey; and
  • 2 Philips Healthcare, Cardiovascular Innovation, Best, The Netherlands
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Object

The small size and tortuous anatomy of intracranial arteries require that flow-diverter stents in the intracranial vasculature have a low profile, high flexibility, and excellent trackability. However, these features limit the degree of radiopacity that can be incorporated into the stents. Visualization of these stents and the degree of stent deployment using conventional radiographic techniques is suboptimal. To overcome this drawback, the authors used a new combined angiography/CT suite that uses flat-panel detector technology for higher resolution angiography.

Methods

The authors present their preliminary experience in the imaging of flow-diverter stents in 31 patients in whom VasoCT was used with a new flat-panel detector angiographic system.

Results

Intraarterial VasoCT was performed after flow-diverter stent deployment in all cases. In 4 of these cases, balloon angioplasty or telescopic stent deployment–related decisions were made after checking VasoCT images.

At 3- and 6-month follow-up in 27 patients, digital subtraction angiography was performed in 12 patients and intravenous VasoCT in 11 patients. Twenty-three of 31 patients had their aneurysm occluded during short-term follow-up, and 4 of the 31 patients still had minimal residual filling of the aneurysms. None of the 27 patients had stenosis of the parent artery.

Conclusions

The authors found that VasoCT provides clear visualization of flow-diverter stents. The images obtained both intraarterially and intravenously are very promising. The initial results provide a high confidence and reproducibility rate for further utilization of this new technique.

Abbreviations used in this paper:DSA = digital subtraction angiography; ICA = internal carotid artery.

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Contributor Notes

Address correspondence to: Naci Kocer, M.D., Department of Radiology, Division of Neuroradiology, University of Istanbul, Cerrahpasa Medical School, Kocamustafapasa, 34098 Istanbul, Turkey. email: nkocer@istanbul.edu.tr.

Please include this information when citing this paper: published online May 4, 2012; DOI: 10.3171/2012.4.JNS111660.

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