Low Yield of Cerebral Angiography in Adequately Occluded Aneurysms After Flow Diversion.
Publication/Presentation Date
12-1-2018
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.
Volume
83
Issue
6
First Page
1294
Last Page
1297
ISSN
1524-4040
Published In/Presented At
Chalouhi, N., Patel, P. D., Atallah, E., Starke, R. M., Chitale, A., Lang, M., Tjoumakaris, S., Hasan, D., Zarzour, H., Smith, M. J., Rosenwasser, R., & Jabbour, P. (2018). Low Yield of Cerebral Angiography in Adequately Occluded Aneurysms After Flow Diversion. Neurosurgery, 83(6), 1294–1297. https://doi.org/10.1093/neuros/nyx625
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
29518235
Department(s)
Administration and Leadership
Document Type
Article