Neuroangiography: Review of Anatomy, Periprocedural Management, Technique, and Tips

Abstract

Neuroangiography (NA) is a minimally invasive procedure used to diagnose patients with neurovascular diseases. Noninvasive imaging has improved dramatically in recent years and is utilized more frequently; however, further evaluation with NA is still required in certain cases. NA indications include intracranial (cerebral aneurysms, arteriovenous malformations, dural arteriovenous fistula, cerebral vasculitis, cerebral vasospasm, ischemic stroke, nontraumatic subarachnoid hemorrhage, intracerebral hemorrhage, Moyamoya, vein of Galen malformation, intracranial tumors, and pseudotumor cerebri) and extracranial (internal and common carotid artery stenosis, vertebral artery stenosis, carotid artery blowout, vertebral artery blowout, epistaxis, oropharyngeal bleeding, and carotid body tumor) pathologies which can help with diagnosis and potential subsequent endovascular treatment. A thorough understanding of normal and variant cervical/cranial vascular anatomy is required. In addition, periprocedural management, catheter technique, equipment needed, and underlying disease pathology are paramount to successful and safe outcomes. This article will review basic neurovascular anatomy, periprocedural management, NA technique, and tips for safe and successful outcomes.

Identifying risk factors for perioperative thromboembolic complications in patients treated with the Woven EndoBridge device

“…Increased procedure time has been linked to increased rate of complications during neurointerventional procedures. 16 This is likely because procedure length can be seen as a surrogate marker of the complexity of the procedure. In patients with tortuous vessels, anatomic variations, long standing vascular disease, and complex shaped aneurysms, performing an endovascular treatment with WEB is challenging and will take longer.…”

Regarding “CTA Evaluation of Basilar Septations: An Entity Better Characterized as Aberrant Basilar Fenestrations”

“…It is possible, however, that this, in fact, represents a further transversely orientated variant of basilar fenestration morphology, not conforming directly to the classification described by Small et al We have been unable to identify additional previously described examples of this in the literature. [2][3][4] Incidentally, the patient's imaging also demonstrated a right-sided persistent trigeminal artery (Fig 2).…”