Journal article
Low Yield of Cerebral Angiography in Adequately Occluded Aneurysms After Flow Diversion
Neurosurgery, Vol.83(6), pp.1294-1297
12/01/2018
DOI: 10.1093/neuros/nyx625
PMID: 29518235
Abstract
Abstract
BACKGROUND
Flow diversion has emerged as a highly effective treatment for intracranial aneurysms.
OBJECTIVE
To assess the yield of further angiographic follow-up in aneurysms that have achieved adequate occlusion after treatment with the Pipeline Embolization Device (PED; Medtronic Inc, Dublin, Ireland).
METHODS
This is a single-institution, retrospective study. Inclusion criteria were as follows: (1) patients with 1 or more aneurysms treated with PED, (2) available short-term (<12 mo) follow-up digital subtraction angiography (DSA), (3) complete (100%) or near-complete (>95%) occlusion on short-term follow-up DSA, and (4) available further angiographic follow-up (DSA, Magnetic Resonance Angiography (MRA), or Computed Tomography Angiography (CTA)).
RESULTS
A total of 146 patients were identified. Aneurysm size was 8.4 ± 5.1 mm on average. Mean angiographic follow-up time was 29.7 ± 12.2 mo. On short-term follow-up DSA images, 132 (90.4%) had complete aneurysm occlusion and 14 (9.6%) had near-complete occlusion. Four patients (3%) had further DSA follow-up alone, 30 patients (21%) had further DSA and MRA/CTA follow-up, and 112 patients (76%) had further MRA/CTA follow-up alone. On further angiographic follow-up (DSA, MRA, and/or CTA), no patient had a decrease in the degree of aneurysm occlusion (recurrence) or required retreatment. Of the 14 patients with near-complete occlusion on initial DSA images, 7 patients (50%) progressed to complete aneurysm occlusion on further angiographic follow-up.
CONCLUSION
This study did not find any diagnostic yield in repeating cerebral angiography in adequately occluded aneurysms with the PED. We do not recommend repeat angiographic follow-up once aneurysms have achieved complete occlusion with the PED unless clinically warranted.
Details
- Title: Subtitle
- Low Yield of Cerebral Angiography in Adequately Occluded Aneurysms After Flow Diversion
- Creators
- Nohra Chalouhi - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaPurvee D Patel - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaElias Atallah - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaRobert M Starke - Department of Neurosurgery & Radiology, Miami Miller School of Medicine, Miami University Hospital, Miami, FloridaAmeet Chitale - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaMichael Lang - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaStavropoula Tjoumakaris - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaDavid Hasan - Department of Neurosurgery, University of Iowa, Iowa City, IowaHekmat Zarzour - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaMichelle J Smith - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaRobert Rosenwasser - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaPascal Jabbour - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania
- Resource Type
- Journal article
- Publication Details
- Neurosurgery, Vol.83(6), pp.1294-1297
- Publisher
- Oxford University Press
- DOI
- 10.1093/neuros/nyx625
- PMID
- 29518235
- ISSN
- 0148-396X
- eISSN
- 1524-4040
- Language
- English
- Date published
- 12/01/2018
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurosurgery; Otolaryngology
- Record Identifier
- 9984040278402771
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