Digital Subtraction Angiography May Reduce the Rate of Radiographic Hemorrhage in Stereoelectroencephalography.
Publication/Presentation Date
8-1-2022
Abstract
OBJECTIVE: To study the effect of preoperative digital subtractive angiography (DSA) for planning stereoelectroencephalography (sEEG) electrode trajectories on the rate of postoperative radiographic hemorrhage.
METHODS: A retrospective, single-center observational study was conducted examining every sEEG implantation consisting of 72 implantations of 1028 total electrodes with each patient having received a preoperative planning DSA. Postimplant imaging was analyzed for the presence of hemorrhage. Postoperative computed tomography were then merged and coregistered with preoperative DSA to determine if a collision or near-miss (within 1 mm) occurred between the perihemorrhage electrodes and a vessel. Statistical analysis was then conducted.
RESULTS: Six patients (8.3%) had hemorrhage seen on computed tomography with a bleeding rate of 0.6% per electrode. Five patients were asymptomatic (6.94%) and one symptomatic (1.39%). One patient suffered permanent neurologic deficits, and there have been zero deaths. In the hemorrhage group, there were 3 subdural, 2 subarachnoid, and 2 intraparenchymal. All subdural and subarachnoid hemorrhages had electrodes that were found to collide or near-miss a vessel when compared with preoperative DSA. Half of the intraparenchymal hemorrhages had no obvious vessel in proximity to the electrodes. Our data show that preoperative DSA is a viable screening test and portends a 94.7% sensitivity and 53.6% specificity for predicting post operative radiographic hemorrhage.
CONCLUSIONS: Analysis of our sEEG series reveals a substantially lower rate of postimplant hemorrhage when compared with the recent cohort studies. Our data indicate that preoperative DSA may be efficacious in reducing the incidence of sEEG postimplant hemorrhages.
Volume
164
First Page
964
Last Page
964
ISSN
1878-8769
Published In/Presented At
Stefanelli, A., Sabourin, V., Hines, K., Matias, C., Acharya, S., Sharan, A., & Wu, C. (2022). Digital Subtraction Angiography May Reduce the Rate of Radiographic Hemorrhage in Stereoelectroencephalography. World neurosurgery, 164, e964–e969. https://doi.org/10.1016/j.wneu.2022.05.081
Disciplines
Medicine and Health Sciences
PubMedID
35643404
Department(s)
Department of Surgery
Document Type
Article
