Discrepancy between two-dimensional and three-dimensional digital subtraction angiography for the planning of endovascular coiling of small cerebral aneurysms < 5 mm

doi:10.1177/1591019920925706

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Title:	Discrepancy between two-dimensional and three-dimensional digital subtraction angiography for the planning of endovascular coiling of small cerebral aneurysms < 5 mm
Authors:	Wu, Te-Chang Tsui, Yu-Kun Chen, Tai-Yuan Ko, Ching-Chung Lin, Chien-Jen Chen, Jeon-Hor Lin, Ching-Po
Contributors:	Chi Mei Med Ctr, Dept Med Imaging Natl Yang Ming Univ, Dept Biomed Imaging & Radiol Sci Chang Jung Christian Univ, Dept Med Sci Ind Chang Jung Christian Univ, Grad Inst Med Sci Chia Nan Univ Pharm & Sci, Ctr Humanities & Soc I Shou Univ, Dept Radiol, E Da Hosp, E Da Canc Ctr Univ Calif Irvine, Sch Med, Ctr Funct Oncoimaging Radiol Sci, Irvine Natl Yang Ming Univ, Inst Neurosci, Sch Life Sci
Keywords:	Cerebral aneurysm angiography endovascular coiling
Date:	2020
Issue Date:	2022-11-18 11:25:19 (UTC+8)
Publisher:	Sage Publications Inc
Abstract:	Background To investigate the discrepancy between two-dimensional digital subtraction angiography and three-dimensional rotational angiography for small (<5 mm) cerebral aneurysms and the impact on decision making among neuro-interventional experts as evaluated by online questionnaire. Materials and methods Eight small (<5 mm) ruptured aneurysms were visually identified in 16 image sets in either two-dimensional or three-dimensional format for placement in a questionnaire for 11 invited neuro-interventionalists. For each set, two questions were posed: Question 1: Which of the following is the preferred treatment choice: simple coiling, balloon remodeling or stent assisted coiling?; Question 2: Is it achievable to secure the aneurysm with pure simple coiling? The discrepancies of angio-architecture parameters and treatment choices between two-dimensional-digital subtraction angiography and three-dimensional rotational angiography were evaluated. Results In all eight cases, the neck images via three-dimensional rotational angiography were larger than two-dimensional-digital subtraction angiography with a mean difference of 0.95 mm. All eight cases analyzed with three-dimensional rotational angiography, but only one case with two-dimensional-digital subtraction angiography were classified as wide-neck aneurysms with dome-to-neck ratio < 1.5. The treatment choices based on the two-dimensional or three-dimensional information were different in 56 of 88 (63.6%) paired answers. Simple coiling was the preferred choice in 66 (75%) and 26 (29.6%) answers based on two-dimensional and three-dimensional information, respectively. Three types of angio-architecture with a narrow gap between the aneurysm sidewall and parent artery were proposed as an explanation for neck overestimation with three-dimensional rotational angiography. Conclusions Aneurysm neck overestimation with three-dimensional rotational angiography predisposed neuro-interventionalists to more complex treatment techniques. Additional two-dimensional information is crucial for endovascular treatment planning for small cerebral aneurysms.
Relation:	Interventional Neuroradiology, v.26, n.6, pp.8
Appears in Collections:	[Dept. of Health and Nutrition (including master's program)] Periodical Articles

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