gms | German Medical Science

61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010
Joint Meeting mit der Brasilianischen Gesellschaft für Neurochirurgie am 20. September 2010

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21. - 25.09.2010, Mannheim

IvACT after aneurysm clipping as an alternative to digital subtraction angiography – first experiences

Meeting Abstract

Suche in Medline nach

  • Dorothee Wachter - Abteilung für Neurochirurgie, Georg-August-Universität Göttingen, Deutschland
  • Marios Psychogios - Abteilung für Neuroradiologie, Georg-August-Universität Göttingen, Deutschland
  • Michael Knauth - Abteilung für Neuroradiologie, Georg-August-Universität Göttingen, Deutschland
  • Veit Rohde - Abteilung für Neurochirurgie, Georg-August-Universität Göttingen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1583

DOI: 10.3205/10dgnc058, URN: urn:nbn:de:0183-10dgnc0586

Veröffentlicht: 16. September 2010

© 2010 Wachter et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: After clipping of intracranial aneurysms, aneurysm remnants and inadvertent vessel occlusion are seen on digital subtraction angiography (DSA) in up to 10% of the cases, raising the question if routine postoperative angiographic control should be recommended. On the other hand, DSA carries a certain risk of stroke, leading to the search for less invasive diagnostic tools such as CT angiography. Very recently, intravenous angiographic computed tomography (ivACT) was introduced which has the advantage of reduced radiation dosage and the ability to generate multiplanar images. It is the aim of the study to investigate if ivACT has the potential to replace DSA after aneurysm clipping.

Methods: Twenty patients (14 female, 6 male) underwent surgical clipping of 14 ruptured and nine innocent aneurysms. Two patients presented with multiple aneurysms. Postoperative ivACT as well as DSA was performed in all patients.

Results: Seventeen patients had complete aneurysm clipping proved in both DSA and ivACT. In two patients small neck remnants of 1.5 and 3 mm without need for further therapy were diagnosed by ivACT and confirmed by subsequent postoperative DSA. In one patient with a large innocent infraclinoidal ICA aneurysm, a broad based neck remnant was seen on ivACT and DSA.

Conclusions: This study illustrates the efficacy of ivACT digital angiography for postoperative control of surgically treated aneurysms. The quality of ivACT generated images seams to be sufficient in the detection of residual aneurysms after clipping. In case of insecure results, postoperative DSA should be performed to obtain further details.