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Related Experiment Videos

Intra-aneurysmal pressure changes during angiography in coil embolization

T Sorimachi1, S Takeuchi, T Koike

  • 1Department of Neurosurgery, Niigata University, Japan.

Surgical Neurology
|November 14, 1997
PubMed
Summary

Injection of contrast medium during angiography significantly elevates intra-aneurysmal pressure, potentially causing rerupture of cerebral aneurysms. This study confirms the pressure increase using microcatheter measurements in patients.

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Area of Science:

  • Neurosurgery
  • Vascular Imaging
  • Medical Device Technology

Background:

  • Rupture of cerebral aneurysms during angiography is a serious complication.
  • Elevation of intra-aneurysmal pressure from contrast injection is a suspected cause of rerupture.
  • Direct measurement of intra-aneurysmal pressure during angiography has been technically challenging.

Purpose of the Study:

  • To demonstrate that contrast medium injection elevates intra-aneurysmal pressure.
  • To validate microcatheter-based pressure measurement accuracy.
  • To investigate the clinical significance of contrast-induced pressure changes in cerebral aneurysms.

Main Methods:

  • Validated microcatheter pressure measurement accuracy using a plastic aneurysm model.
  • Measured intra-aneurysmal pressure in nine human cerebral aneurysms during angiography.

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  • Recorded pressure changes immediately following contrast medium injection.

    • Main Results:

    • Microcatheter pressure measurements accurately reflected pressure changes in the model.
    • Intra-aneurysmal systolic pressure increased by 5-23 mm Hg in most aneurysms post-injection.
    • No significant pressure changes were observed in one posterior cerebral artery aneurysm; systemic blood pressure remained stable.

    Conclusions:

    • Contrast medium injection causes a rapid, significant elevation in intra-aneurysmal pressure.
    • This pressure surge may increase the risk of aneurysm rerupture, particularly in fragile, recently ruptured aneurysms.
    • Microcatheter technology enables direct measurement of these critical hemodynamic changes during angiography.