Before emergency aneurysm surgery, CTA or DSA? A single center experience

Area of Science:

• Neurosurgery
• Neuroradiology
• Vascular Neurology

Background:

• Subarachnoid hemorrhage (SAH) from intracranial aneurysms is a critical surgical emergency.
• Accurate and timely aneurysm visualization is crucial for effective treatment planning.
• CT Angiography (CTA) and Digital Subtraction Angiography (DSA) are key diagnostic modalities.

Purpose of the Study:

• To compare the diagnostic utility and clinical impact of CTA versus DSA in patients with SAH.
• To evaluate patient demographics, aneurysm characteristics, and outcomes between the two imaging groups.
• To determine surgeon preference based on imaging fidelity and procedural efficiency.

Main Methods:

• Retrospective analysis of 58 patients with SAH and intracranial aneurysms.
• Patients were divided into CTA (n=30) and DSA (n=28) groups.
• Evaluation included demographic data, imaging findings, aneurysm location, Fisher score, complications, and Glasgow Outcome Score.

Main Results:

• The most frequent aneurysm location was the M1 segment (48.3%).
• Patients undergoing DSA experienced significantly longer hospital stays (p=0.021).
• No significant difference in postoperative complications was observed between CTA and DSA groups.

Conclusions:

• Advanced CT Angiography offers higher fidelity imaging and can reduce hospital stays.
• CTA may expedite emergency surgical interventions by providing timely diagnoses.
• While DSA remains valuable, its invasive nature and longer diagnostic time are considerations.