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Intra-arterial haemodynamic changes during cerebral three-dimensional rotational angiography
Peter Waldenberger1, Andreas Chemelli, Ammar Mallouhi
1Department of Radiology, St. Vincent Hospital, Seilerstätte 4, 4010 Linz, Austria. Peter.Waldenberger@bhs.at
European Radiology
|September 17, 2008
Summary
Three-dimensional rotational angiography (3DRA) involves contrast material injection that temporarily increases blood pressure in selected arteries. These hemodynamic changes during 3DRA are significant but clinically tolerable for aneurysm treatment planning.
Area of Science:
- Interventional Neuroradiology
- Cerebrovascular Imaging
- Hemodynamics
Background:
- Three-dimensional rotational angiography (3DRA) is crucial for diagnosing and planning treatments for intracranial aneurysms.
- Prolonged contrast material (CM) injection during 3DRA may alter hemodynamics in the targeted artery.
Purpose of the Study:
- To evaluate the extent and clinical significance of hemodynamic alterations in arteries during 3DRA procedures.
- To assess the impact of CM injection on intra-arterial pressure and fractional flow reserve (FFR).
Main Methods:
- Prospective study of 25 patients with intracranial aneurysms undergoing 3DRA.
- Intra-arterial pressure monitoring using a pressure guidewire in the internal carotid or vertebral artery.
- Measurement of mean and systolic blood pressure (Pd) and FFR before, during, and after CM injection.
Main Results:
- A significant increase in mean systolic Pd (P<0.001) and FFR (P<0.001) was observed during CM injection.
- Pd and FFR returned to baseline levels post-injection.
- Moderate correlation and agreement were found between baseline and during-injection measurements for Pd and FFR.
Conclusions:
- Selective CM injection during 3DRA induces transient, yet clinically acceptable, elevations in blood pressure and pressure gradients.
- These hemodynamic changes do not appear to compromise the diagnostic utility of 3DRA for aneurysm management.
