Intravenous VasoCT for the Follow-up of Intracranial Aneurysms Treated with Flow-Diverter Stents: Feasibility and...

There is no consensus regarding the optimal imaging technique for assessing aneurysms treated with flow diverters (FDs). The goal was to evaluate the image quality of IV-VasoCT in the follow-up of aneurysms treated with FDs and to explore its potential for depicting braid stent deformation and vessel lumen modifications.

We retrospectively enrolled patients who underwent FD placement for the treatment of aneurysms, with posttreatment IV-VasoCT at 1-3 months and DSA by at least 6 months. IV-VasoCT image quality assessment evaluated vessel opacification, vessel border, stent radiopacity, stent/vessel contrast, and movement artifacts. Braid stent and parent vessel findings were compared between IV-VasoCT and DSA in terms of neointimal lining, stent foreshortening, fish-mouthing, bumping, and braid collapse.

Twenty-six aneurysms were evaluated in 24 patients (woman/man: 15/9), with a median age of 54.5 years (interquartile range: 47.0-59.0 years). The in-consensus image quality reading evaluated: vessel opacification as optimal in 19 cases (73.1%); vessel borders as well-defined in 17 (65.4%); stent radiopacity as well-defined in 25 (96.2%); and stent/vessel contrast as optimal in 20 (76.9%). Compared with DSA, IV-VasoCT diagnosed 2 of 3 (66%) cases of neointimal lining, 2 of 2 (100%) cases of fish-mouth, 1 of 2 (50%) cases of foreshortening, 3 of 6 (50%) cases of bumping, and 2 of 2 (100%) cases of braid collapse.

IV-VasoCT is feasible for the noninvasive follow-up of aneurysms treated with FDs. It may depict modifications in braid stent and vessel neointimal lining, but the presence of coils may reduce its image quality because of artifacts.