Digital Subtraction Angiography a Door Opener for Neurosurgical Residents who want to Perform Neurointerventional Procedures

Rajbhandari, Pradeep; Gurung, Pritam; Rajbhandari, Sujeeb; Shrestha, Deepak; Acharya, Sameer; Shrestha, Ramchandra; Shrestha, Prakash; Shrestha, J; Sharma, Utkarsh; Mali, S. P. M.; Rajbhandari, Reema; Neupane, Anish; Pant, Basant

doi:10.3126/kumj.v19i1.49595

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…CT Angiography and Digital Subtracted Angiography were used as investigative tool to diagnose aneurysm. 11,12 Nevertheless absurdity and imprudent counsel from the referring physicians who may have falsely labeled grade I SAH as simple headache has also been recited in our overview. 10 Besides, as high as 81% of our patients as evidenced by CTA presented with ruptured aneurysms, because of lack of awareness among the community from the concerned authority to formulate a screening setup among the vulnerable.…”

Section: Postoperative Complications and Its Managementmentioning

confidence: 97%

An Audacious Voyage during COVID-19 Pandemic in Management of Patients with Aneurysmal Subarachnoid Hemorrhage at Annapurna Neurological Institute and Allied Sciences

et al. 2022

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Introduction: Aneurysmal Subarachnoid Hemorrhage(SAH) is a neurosurgical emergency for which testing for COVID PCR was not an option and was unlikely to change the management of the case. Hence, all surgeries were performed without COVID PCR and Rapid Diagnostic Test (RDT) at our center for the welfare of the patient despite risks involved for the surgeons and supporting staff. Methods: Data were collected retrospectively of all cerebral aneurysm patients who received treatment at Annapurna Neurological Institute and Allied Sciences during the covid pandemic between February 2020 to May 2021. Their demographic profile, clinical and imaging characteristics, treatment decision, postoperative complication, postoperative functional status in terms of Modified Rankin Scale were taken into consideration and analyzed. Result: 63 patients were enrolled in study with patient age ranging from 9 years to 81 years. Male to female ratio was 1:3. Amongst them, 28% had hypertension. 82% underwent microsurgical clipping while three patients underwent coiling. Basilar Top aneurysm, Para clinoid aneurysm, PICA aneurysm underwent simple coiling. Wrapping, bypass and trapping were performed in 1,1, and 3 cases respectively. At the time of discharge, most of the patients (77%) achieved good functional recovery (mRS ≤ 2) while mortality was reported in 8% of patients. Based on our experience and limited dataset, posterior location of aneurysm, increasing HuntHess Grade and modified fisher grade had poor prognosis, related with degree of cerebral vasospasm, and delayed cerebral ischemia. Conclusion: Results from our study showed outcomes in surgical patients with aneurysmal SAH at par with international standards. COVID pandemic although posed initial difficulties, with proper guidelines and protocols in place, we were able to perform the emergency surgeries without compromising our standards.

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Section: Postoperative Complications and Its Managementmentioning

confidence: 97%

An Audacious Voyage during COVID-19 Pandemic in Management of Patients with Aneurysmal Subarachnoid Hemorrhage at Annapurna Neurological Institute and Allied Sciences

et al. 2022

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Comparing DCE‐MRI and DSA: Understanding the embolization of hypervascular spinal metastases

Adnan,

Farukh,

Ali

et al. 2024

J Med Imag Rad Onc

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SummaryThis study aims to examine and compare the effectiveness of dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI) and Digital Subtraction Angiography (DSA) in evaluating hypervascular spinal metastases. A comprehensive literature review was conducted, utilizing top‐tier databases such as PubMed, Scopus and Google Scholar, to compile an authoritative and up‐to‐date overview of the current advancements in the field. We synthesized key studies focusing on the advantages, limitations and efficacy of both imaging techniques. DCE‐MRI provides a non‐invasive method for evaluating tissue morphology, perfusion and vascularity, offering valuable information for cancer diagnosis and treatment monitoring. In contrast, DSA is an invasive procedure primarily used for embolization and diagnosing cerebrovascular events. Both modalities have distinct features regarding image acquisition, contrast agents, resolution and accessibility. DCE‐MRI shows promise for cancer‐related applications, offering advantages over conventional MRI by incorporating anatomical and hemodynamic parameters. While DSA remains important for cases requiring critical vascular information, further research is necessary to explore its potential therapeutic benefits in assessing vessel patency. Continued investigations are crucial to uncover additional insights and therapeutic applications for both DCE‐MRI and DSA in medical imaging.

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Clinical Effect of Digital Subtraction Angiography Combined with Neurointerventional Thrombolysis for Acute Ischemic Cerebrovascular Disease and Its Influence on Vascular Endothelial Function and Oxidative Stress

Wang

Guan

Wang

2022

Oxidative Medicine and Cellular Longevity

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Objective. Ischemic cerebrovascular disease is a commonly seen vascular disorder in clinical practice. Given the difficulty of drug therapy to achieve ideal curative effects, interventional therapy has gradually become the preferred treatment for the disease. This research primarily discusses the short-term efficacy of digital subtraction angiography- (DSA-) guided neurointerventional thrombolysis for acute ischemic cerebrovascular disease (AICVD) and its influence on vascular endothelial function (VEF) and oxidative stress (OS). Methods. All the clinical data of 162 patients diagnosed with AICVD and treated between June 2019 and December 2021 were collected and analyzed retrospectively. They were assigned to two cohorts according to the difference in interventional methods: a conventional group (CG) given recombinant tissue plasminogen activator (rt-PA) therapy and an observation group (OG) intervened by DSA-guided neurointerventional thrombolysis. The two groups were compared with respect to short-term treatment efficacy, the National Institutes of Health Stroke Scale (NIHSS) score, cerebral hemodynamics, and VEF and OS indexes. Results. The short-term efficacy was better in OG (93.98%) than in CG (82.28%). After treatment, the NIHSS score decreased in both cohorts with obvious differences within the group at different time points, and the posttreatment NIHSS score was lower in OG as compared to CG. OG had higher Q m and V m while lower W v , Z cv , and R v than CG. Higher endothelial-dependent flow-mediated dilatation (FMD) was observed in OG, as well as lower ankle-brachial index (ABI) and pulse wave velocity (PWV). And the posttreatment MDA was lower while SOD, GSH-Px, and TAC were higher in OG compared with those on CG. All the above differences were of statistical significance ( P < 0.05 ). Conclusions. DSA-guided neurointerventional thrombolysis is highly effective in the treatment of AICVD, which can not only effectively improve patients’ neurological function and cerebral hemodynamics but also mitigate VEF injury and help to alleviate patients’ OS.

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Digital Subtraction Angiography a Door Opener for Neurosurgical Residents who want to Perform Neurointerventional Procedures

Cited by 3 publications

References 8 publications

An Audacious Voyage during COVID-19 Pandemic in Management of Patients with Aneurysmal Subarachnoid Hemorrhage at Annapurna Neurological Institute and Allied Sciences

An Audacious Voyage during COVID-19 Pandemic in Management of Patients with Aneurysmal Subarachnoid Hemorrhage at Annapurna Neurological Institute and Allied Sciences

Comparing DCE‐MRI and DSA: Understanding the embolization of hypervascular spinal metastases

Clinical Effect of Digital Subtraction Angiography Combined with Neurointerventional Thrombolysis for Acute Ischemic Cerebrovascular Disease and Its Influence on Vascular Endothelial Function and Oxidative Stress

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