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Summary

Finding the best fluoroscopic view for cerebral aneurysm coiling is crucial. Rotation digital subtraction angiography (DSA), guided by 3D CT angiography, effectively predicts optimal views, preventing coil protrusion.

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Area of Science:

  • Neurosurgery
  • Interventional Radiology
  • Medical Imaging

Background:

  • Preventing coil protrusion into the parent artery during cerebral aneurysm coiling is critical for successful endovascular treatment.
  • Identifying the optimal fluoroscopic view for coil packing can be challenging.

Purpose of the Study:

  • To evaluate the utility of rotation digital subtraction angiography (DSA) in predicting the optimal fluoroscopic view for endovascular treatment of cerebral aneurysms.
  • To assess the effectiveness of combining 3D CT angiography with rotation DSA.

Main Methods:

  • Rotation DSA was applied to four cerebral aneurysm cases.
  • Three-dimensional CT angiography (3D-CT angiography) was used to pre-estimate the C-arm rotation range.
  • C-arm rotation was limited to 60 degrees, with a limited number of DSA shots.

Main Results:

  • Rotation DSA proved useful in determining the optimal fluoroscopic view for coil packing.
  • The combination of 3D-CT angiography pre-estimation and rotation DSA facilitated the prediction of optimal views.

Conclusions:

  • Rotation DSA is a valuable tool for optimizing fluoroscopic views in cerebral aneurysm endovascular treatment.
  • Pre-estimation with 3D-CT angiography enhances the efficiency and accuracy of rotation DSA for determining optimal fluoroscopic angles.