In vitro comparison of intracranial stent visibility using various concentrations of gadolinium contrast agent under 1.5 T and 3 T MR angiography

Chiang, Chen-Hua; Tseng, Yi‐Ping; Chen, Ai Chi; Huang, Yen Lin; Chen, David Yen Ting; Chen, Chi Jen; Lin, Yen Kuang; Hsu, Hui Ling

doi:10.1136/neurintsurg-2016-012490

Cited by 5 publications

(4 citation statements)

References 20 publications

(27 reference statements)

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“…A previous study analyzed stent wall apposition with post-treatment 3 T MRA and contrast-enhanced flat-panel CT ( 4 ). Postoperative MRI with gadolinium enhancement is another option to evaluate the stent structure and vessels surrounding the aneurysm ( 5 ). However, these modalities cannot be applied intraoperatively and provide only 2D slice images.…”

Section: Discussionmentioning

confidence: 99%

“…Heller et al reported that 36% of patients who had undergone stent-assisted coil embolization for cerebral aneurysms showed perioperative ischemic events due to incomplete stent apposition to the vessel wall ( 3 , 4 ). Although accurate radiological assessment of stent apposition to the parent vessel and neointimal formation inside the stent is required to avoid periprocedural complications in the treatment of intracranial aneurysms, few reports have described in-stent neointimal formation in addition to stent apposition to the vessel wall using computed tomography (CT), magnetic resonance imaging (MRI), and digital subtraction angiography (DSA) ( 5 , 6 ). Neointimal formation after stent-assisted coil embolization has recently been evaluated using optical coherence tomography (OCT) and optical frequency domain imaging (OFDI) ( 7 , 8 ), but those intravascular imaging modalities are invasive when assessing intracranial stents.…”

Section: Introductionmentioning

confidence: 99%

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Three-dimensional reconstruction imaging by C-arm computed tomography accurately visualizes in-stent neointimal formation in patients with stent-assisted coil embolization

et al. 2023

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BackgroundStent apposition to the vessel wall and in-stent neointimal formation after stent-assisted coil embolization for intracranial aneurysm are important factors associated with postoperative thromboembolic complications. No assessment methods have been established to depict 3-dimensional (3D) all-round in-stent neointimal formation.ObjectiveTo demonstrate the superiority of Dyna-3D imaging assessment as a modality for all-round ISNF in comparison with conventional two-dimensional digital subtraction angiography (2D-DSA).MethodsConsecutive patients who underwent braided stent-assisted coil embolization for unruptured aneurysm between November 2016 and September 2021 were enrolled. Radiological assessments for stent apposition to the parent vessel after stent deployment and in-stent neointimal formation after 3 months were obtained. Dyna-3D was reconstructed by overlapping a plain image showing stent struts with a rotational DSA image showing the vessel lumen. Reconstructed Dyna-3D images can be rotated to any angle on the screen to evaluate to stent apposition around the vessel and in-stent neointimal formation in 3D, for comparison with 2D-DSA evaluations.ResultsAmong the 73 patients enrolled, 70 patients (96%) showed complete stent wall apposition on Dyna-3D. Higher intra-rater agreement was confirmed on assessment of in-stent neointimal formation with Dyna-3D (Cohen’s κ = 0.811) than with conventional 2D-DSA (Cohen’s κ = 0.517). in-stent neointimal formation could not be confirmed on conventional imaging in 9 cases (16%) and on Dyna-3D in 2 cases (3%). The number of in-stent neointimal formations rated as stent wire completely outside the endothelial line was significantly higher with Dyna-3D than with 2D-DSA (p = 0.0001).ConclusionAll-round 3D evaluation by Dyna-3D imaging appears useful for confirming in-stent neointimal formation after braided stent deployment in patients after stent-assisted coil embolization.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Three-dimensional reconstruction imaging by C-arm computed tomography accurately visualizes in-stent neointimal formation in patients with stent-assisted coil embolization

et al. 2023

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“…Studies on stent visibility or stent malapposition have been previously reported using different imaging techniques. Postoperative MRI with gadolinium injection can be an option to evaluate the stent structure and vessels surrounding the aneurysm 16. Intraoperative optical coherence tomography has also emerged as a modality to evaluate stent apposition and thrombus organization 17.…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative MRI with gadolinium injection can be an option to evaluate the stent structure and vessels surrounding the aneurysm. 16 Intraoperative optical coherence tomography has also emerged as a modality to evaluate stent apposition and thrombus organization. 17 However, this technique requires a special catheter insertion into the vessels in question.…”

Section: Discussionmentioning

confidence: 99%

Visualization of stent apposition after stent-assisted coiling of intracranial aneurysms using high resolution 3D fusion images acquired by C-arm CT

Kato

Yuki

Ishibashi

et al. 2019

J NeuroIntervent Surg

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PurposeWe used an imaging technique based on 3-dimensional (3D) C-arm CT to assess the apposition of three types of stents after coiling of intracranial aneurysms.MethodsAll patients with intracranial aneurysms were considered who received stent-assisted coiling with Enterprise2, Neuroform EZ, or Neuroform Atlas stents confirmed by C-arm CT imaging at our institution between June 2015 and November 2017. A 3D digital subtraction angiography (DSA) scan for vessel imaging followed by a high-resolution cone beam CT (HR-CBCT) scan for coil and stent imaging was performed. The images were fused to obtain dual volume 3D fusion images. We investigated malapposition of the stent trunk (crescent sign) and of the stent edges (edge malapposition) and used the χ2 statistic to test for an association with stent types. Inter-rater agreement between two raters was estimated using Cohen’s kappa statistics.ResultsWe evaluated 75 consecutive cases. Enterprise2 stents were used in 22 cases, Neuroform EZ in 26, and Neuroform Atlas in 27 cases. By stent type, crescent sign was detected in 27% of Enterprise2, 8% of Neuroform EZ, and none of Neuroform Atlas stents (p=0.007), while edge malapposition was detected in 27% of Enterprise2, 58% of Neuroform EZ, and 30% of Neuroform Atlas stents (p=0.05). Excellent (κ=0.81) and good (κ=0.78) agreement between the raters was found for the detection of edge apposition and crescent sign, respectively.ConclusionStent malapposition was clearly visualized by dual volume 3D imaging. The Neuroform Atlas stents showed good apposition even in vessels with strong curvature.

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Flow Diverter Apposition in Patients with Large or Giant Intracranial Aneurysms Evaluated on Three-Dimensional Fusion Images Acquired by High-Resolution Cone-Beam Computed Tomography and Digital Subtraction Angiography

Kato

Yuki

Otani³

et al. 2021

World Neurosurgery

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In vitro comparison of intracranial stent visibility using various concentrations of gadolinium contrast agent under 1.5 T and 3 T MR angiography

Cited by 5 publications

References 20 publications

Three-dimensional reconstruction imaging by C-arm computed tomography accurately visualizes in-stent neointimal formation in patients with stent-assisted coil embolization

Three-dimensional reconstruction imaging by C-arm computed tomography accurately visualizes in-stent neointimal formation in patients with stent-assisted coil embolization

Visualization of stent apposition after stent-assisted coiling of intracranial aneurysms using high resolution 3D fusion images acquired by C-arm CT

Flow Diverter Apposition in Patients with Large or Giant Intracranial Aneurysms Evaluated on Three-Dimensional Fusion Images Acquired by High-Resolution Cone-Beam Computed Tomography and Digital Subtraction Angiography

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