Time-Resolved 3D Contrast-Enhanced MRA on 3.0T: a Non-Invasive Follow-Up Technique after Stent-Assisted Coil Embolization of the Intracranial Aneurysm

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Objective

To evaluate the usefulness of time-resolved contrast enhanced magnetic resonance angiography (4D MRA) after stent-assisted coil embolization by comparing it with time of flight (TOF)-MRA.

Materials and Methods

TOF-MRA and 4D MRA were obtained by 3T MRI in 26 patients treated with stent-assisted coil embolization (Enterprise:Neuroform = 7:19). The qualities of the MRA were rated on a graded scale of 0 to 4. We classified completeness of endovascular treatment into three categories. The degree of quality of visualization of the stented artery was compared between TOF and 4D MRA by the Wilcoxon signed rank test. We used the Mann-Whitney U test for comparing the quality of the visualization of the stented artery according to the stent type in each MRA method.

Results

The quality in terms of the visualization of the stented arteries in 4D MRA was significantly superior to that in 3D TOF-MRA, regardless of type of the stent ( p < 0.001). The quality of the arteries which were stented with Neuroform was superior to that of the arteries stented with Enterprise in 3D TOF ( p < 0.001) and 4D MRA ( p = 0.008), respectively.

Conclusion

4D MRA provides a higher quality view of the stented parent arteries when compared with TOF.

Related collections

Most cited references 31

Record: found
Abstract: found
Article: not found

Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment.

David O Wiebers, J P Whisnant, J. Huston … (2003)

The management of unruptured intracranial aneurysms is controversial. Investigators from the International Study of Unruptured Intracranial Aneurysms aimed to assess the natural history of unruptured intracranial aneurysms and to measure the risk associated with their repair. Centres in the USA, Canada, and Europe enrolled patients for prospective assessment of unruptured aneurysms. Investigators recorded the natural history in patients who did not have surgery, and assessed morbidity and mortality associated with repair of unruptured aneurysms by either open surgery or endovascular procedures. 4060 patients were assessed-1692 did not have aneurysmal repair, 1917 had open surgery, and 451 had endovascular procedures. 5-year cumulative rupture rates for patients who did not have a history of subarachnoid haemorrhage with aneurysms located in internal carotid artery, anterior communicating or anterior cerebral artery, or middle cerebral artery were 0%, 2. 6%, 14 5%, and 40% for aneurysms less than 7 mm, 7-12 mm, 13-24 mm, and 25 mm or greater, respectively, compared with rates of 2 5%, 14 5%, 18 4%, and 50%, respectively, for the same size categories involving posterior circulation and posterior communicating artery aneurysms. These rates were often equalled or exceeded by the risks associated with surgical or endovascular repair of comparable lesions. Patients' age was a strong predictor of surgical outcome, and the size and location of an aneurysm predict both surgical and endovascular outcomes. Many factors are involved in management of patients with unruptured intracranial aneurysms. Site, size, and group specific risks of the natural history should be compared with site, size, and age-specific risks of repair for each patient.

0 comments Cited 452 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Endovascular treatment of unruptured aneurysms.

D. Roy, G Milot, J. Raymond (2001)

We sought to better define the morbidity of endovascular Guglielmi detachable coil (GDC) treatment of unruptured cerebral aneurysms and to discuss its role in the prevention of subarachnoid hemorrhage. We conducted an observational study from August 1992 to June 1999 of 125 unruptured aneurysms treated with GDC in 116 patients: 91 women (78.4%) and 25 men (21.6%), aged 30 to 78 years (mean age, 50.6 years). Immediate and late clinical results were recorded for any neurological event or hemorrhage related to the treated unruptured aneurysm. Angiographic results are reported as immediate, early (2 to 12 months), intermediate (12 to 30 months), and late follow-up (>30 months). Immediate angiographic results showed complete obliteration (class 1) in 59 (47.2%) or residual neck (class 2) in 53 aneurysms (42.4%), leaving 6 residual aneurysms (4.8%) and 7 failures (5.6%). Early follow-up angiograms, available in 100 treated aneurysms (84%), revealed class 1 in 52% and class 2 in 41%. Intermediate angiograms, available in 53 aneurysms (44.5%), showed class 1 in 47.2% and class 2 in 43.4%, while late results, available in 37 lesions (31.1%), had class 1 and 2 in 48.6% and 37.8%, respectively. Six patients suffered a permanent neurological deficit at last follow-up (5.2%), with a good outcome in 5 patients and fair outcome in 1 patient. There was no mortality. There was no aneurysmal rupture during a mean clinical follow-up of 32.1 months. Endovascular treatment with GDC for unruptured aneurysms is relatively safe. Its role in the prevention of aneurysmal rupture remains to be determined, preferably by a randomized study.

0 comments Cited 226 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Risk of recurrent subarachnoid haemorrhage, death, or dependence and standardised mortality ratios after clipping or coiling of an intracranial aneurysm in the International Subarachnoid Aneurysm Trial (ISAT): long-term follow-up

Andrew J. Molyneux, Richard SC Kerr, Jacqueline Birks … (2009)

Summary Background Our aim was to assess the long-term risks of death, disability, and rebleeding in patients randomly assigned to clipping or endovascular coiling after rupture of an intracranial aneurysm in the follow-up of the International Subarachnoid Aneurysm Trial (ISAT). Methods 2143 patients with ruptured intracranial aneurysms were enrolled between 1994 and 2002 at 43 neurosurgical centres and randomly assigned to clipping or coiling. Clinical outcomes at 1 year have been previously reported. All UK and some non-UK centres continued long-term follow-up of 2004 patients enrolled in the original cohort. Annual follow-up has been done for a minimum of 6 years and a maximum of 14 years (mean follow-up 9 years). All deaths and rebleeding events were recorded. Analysis of rebleeding was by allocation and by treatment received. ISAT is registered, number ISRCTN49866681. Findings 24 rebleeds had occurred more than 1 year after treatment. Of these, 13 were from the treated aneurysm (ten in the coiling group and three in the clipping group; log rank p=0·06 by intention-to-treat analysis). There were 8447 person-years of follow-up in the coiling group and 8177 person-years of follow-up in the clipping group. Four rebleeds occurred from a pre-existing aneurysm and six from new aneurysms. At 5 years, 11% (112 of 1046) of the patients in the endovascular group and 14% (144 of 1041) of the patients in the neurosurgical group had died (log-rank p=0·03). The risk of death at 5 years was significantly lower in the coiling group than in the clipping group (relative risk 0·77, 95% CI 0·61–0·98; p=0·03), but the proportion of survivors at 5 years who were independent did not differ between the two groups: endovascular 83% (626 of 755) and neurosurgical 82% (584 of 713). The standardised mortality rate, conditional on survival at 1 year, was increased for patients treated for ruptured aneurysms compared with the general population (1·57, 95% CI 1·32–1·82; p<0·0001). Interpretation There was an increased risk of recurrent bleeding from a coiled aneurysm compared with a clipped aneurysm, but the risks were small. The risk of death at 5 years was significantly lower in the coiled group than it was in the clipped group. The standardised mortality rate for patients treated for ruptured aneurysms was increased compared with the general population. Funding UK Medical Research Council.

0 comments Cited 166 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Korean J Radiol

Journal ID (publisher-id): KJR

Title: Korean Journal of Radiology

Publisher: The Korean Society of Radiology

ISSN (Print): 1229-6929

ISSN (Electronic): 2005-8330

Publication date (Print): Nov-Dec 2011

Publication date (Electronic): 27 September 2011

Volume: 12

Issue: 6

Pages: 662-670

Affiliations

[1 ]Department of Radiology, Konkuk University School of Medicine, Seoul 143-729, Korea.

[2 ]Department of Neurosurgery, Konkuk University School of Medicine, Seoul 143-729, Korea.

[3 ]Department of Neurosurgery, Seoul National University College of Medicine, Seoul 110-744, Korea.

Author notes

Corresponding author: Hong Gee Roh, MD, Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul 143-729, Korea. Tel: (822) 2030-5545, Fax: (822) 2030-5549, hgroh@ 123456kuh.ac.kr

Article

DOI: 10.3348/kjr.2011.12.6.662

PMC ID: 3194769

PubMed ID: 22043147

SO-VID: a47b8627-4563-4e50-8117-327a0afeef0d

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Time-Resolved 3D Contrast-Enhanced MRA on 3.0T: a Non-Invasive Follow-Up Technique after Stent-Assisted Coil Embolization of the Intracranial Aneurysm

Read this article at

Abstract

Objective

Materials and Methods

Results

Conclusion

Related collections

Probing cerebral hemodynamics with BOLD fMRI

Most cited references 31

Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment.

Endovascular treatment of unruptured aneurysms.

Risk of recurrent subarachnoid haemorrhage, death, or dependence and standardised mortality ratios after clipping or coiling of an intracranial aneurysm in the International Subarachnoid Aneurysm Trial (ISAT): long-term follow-up

Author and article information

Journal

Affiliations

Author notes

Article

History

Categories

Comments

Comment on this article

Similar content 178

Cited by 12

Most referenced authors 435