Angiographic C-arm CT visualization of the Woven EndoBridge Cerebral Aneurysm Embolization Device (WEB): First Experience in an Animal Aneurysm Model

Abstract

In vivo C-arm CT imaging of the WEB is feasible and allows precise determination of the position and deployment status of the device. On contrast-enhanced images the occlusion status of aneurysms and the positioning of the WEB in relationship to the parent artery can be evaluated. C-arm-CT may serve as a minimal-invasive follow-up imaging modality.

Intrasaccular flow-diversion for treatment of intracranial aneurysms: the Woven EndoBridge

“…The microcatheter has to be slightly pulled back to partially release the tension to minimize the risk of device movement when it will be detached. Preliminary animal data suggest that angiographic C-arm CT allows precise determination of the position and deployment status of the device [42]. No antiplatelet therapy is required before, during or after treatment unless a stent has to be placed in the artery.…”

High-Resolution C-Arm CT and Metal Artifact Reduction Software: A Novel Imaging Modality for Analyzing Aneurysms Treated with Stent-Assisted Coil Embolization

“…Recent reports show that C-arm CT with contrast has superior spatial resolution compared with conventional CT and allows the visualization of both the deployed stent and the contrast material. 8,[10][11][12] However, once coil embolization is completed, prominent metal artifacts produced by the platinum coils degrade the image quality in the region adjacent to the coil mass, making it extremely difficult to evaluate the minuscule structures around the coil mass. A new prototype software, Metal Artifact Reduction (MAR; Siemens, Erlangen, Germany), dramatically reduces the metal artifacts in C-arm CT imaging by using a novel image-reconstruction algorithm.…”

Imaging Follow-Up of Intracranial Aneurysms Treated by Endovascular Means

“…Applied to WEB, it allows determination of the aneurysm occlusion and of the device position and deployment. 45 Data are scarce on this topic, and controlled studies with larger patient numbers are needed to assess both CTA +++ indicates excellent accuracy, recommended modality for routine follow-up; ++, moderate accuracy, can be used in specific cases; +, low accuracy, limited place in routine actually; ? not evaluated; CE-MRA, contrast-enhanced magnetic resonance angiography; CTA, computed tomographic angiography; DSA, digital subtraction angiography; and TOF, time-of-flight.…”

“…Это позволяет оценить кон-груэнтность стента со стенкой аневризмы и перегибы стентов наряду с оценкой кровотока в мешке аневризмы с высоким разрешением, непосредственно в отделе-нии ангиографии. Применительно к устройству WEB, КТА позволяет оценить полноту окклюзии аневриз-мы, а также положение и размещение устройства [45]. По этому вопросу недостаточно данных и необходимы контролируемые исследования с бóльшим числом паци-ентов для оценки эффективности КТА при наблюдении за аневризмами после установки стента или интрасакку-лярного дезинтегратора кровотока, а также определения специфичности в отношении выявления резидуальных аневризм и гиперплазии интимы по сравнению с дру-гими методами визуализации, в частности ЦСА и МРА.…”