Changes in contrast transit times on digital subtraction angiography post-Pipeline Embolization Device deployment

Area of Science:

• Neurology
• Interventional Radiology
• Medical Imaging

Background:

• Hemodynamic changes in the distal vasculature after Pipeline Embolization Device (PED) placement are postulated.
• Assessing these hemodynamic shifts is crucial for understanding treatment efficacy and potential complications.

Purpose of the Study:

• To evaluate changes in contrast transit times (TTs) using digital subtraction angiography (DSA) after PED interventions.
• To correlate these hemodynamic changes with aneurysm characteristics.

Main Methods:

• DSA imaging was analyzed for time-density relationships at baseline and post-PED deployment in the middle cerebral artery (MCA) M1 segment.
• Key metrics included TT10%-100%, TT100%-10%, and TT25%-25%.
• Forty-four patients were included in the analysis.

Main Results:

• A significant decrease in TT10%-100% (2.79 to 2.24 seconds, p < 0.001) and TT25%-25% (7.07 to 6.41 seconds, p = 0.02) was observed post-PED.
• The percentage change in TT100%-10% correlated significantly with aneurysm size (p = 0.02).
• Changes in TT25%-25% also showed significant correlations with aneurysm size.

Conclusions:

• Statistically significant distal intracranial hemodynamic changes occur after PED deployment.
• These hemodynamic alterations are more pronounced in patients with large and giant aneurysms.