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

Central European Neurosurgery Pub Date : 2010-08-01 Epub Date: 2010-08-19 DOI:10.1055/s-0030-1261946
D Wachter, M Psychogios, M Knauth, V Rohde
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引用次数: 13

Abstract

Objective: After clipping of intracranial aneurysms, digital subtraction angiography (DSA) is recommended for the proof of complete aneurysm occlusion or identification of aneurysm remnants, especially in cases with a more complex angioarchitecture or a difficult operative course. The aim of this study was to evaluate if postoperative intravenous angiographic computed tomography (ivACT) could be a diagnostic alternative in cases of contraindications for DSA.

Material and methods: 13 patients (12 female, 1 male) underwent surgical clipping of 5 ruptured and 10 innocent aneurysms. Postoperative ivACT was performed in all patients due to refusal or contraindications for DSA.

Results: 12 patients had almost complete aneurysm clipping, while 1 patient's was incomplete, which was diagnosed by ivACT and confirmed by subsequent postoperative digital subtraction angiography (DSA), which had been accepted by the patient after clarification of the postoperative findings.

Conclusion: This study illustrates the efficacy of ivACT for postoperative control of surgically treated aneurysms. The quality of ivACT generated images seems to be sufficient in the detection of residual aneurysms after clipping. In cases with inconclusive results, postoperative DSA should be performed to obtain further details.

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动脉瘤夹闭后IvACT作为数字减影血管造影的替代方案-首次经验。
目的:颅内动脉瘤夹闭后,建议采用数字减影血管造影(digital subtraction angiography, DSA)来证明动脉瘤完全闭塞或识别动脉瘤残余,特别是血管结构较复杂或手术过程较困难的病例。本研究的目的是评估术后静脉血管造影计算机断层扫描(ivACT)是否可以作为DSA禁忌症的诊断选择。材料与方法:13例患者(女性12例,男性1例)对5个破裂动脉瘤和10个正常动脉瘤行手术夹闭。由于拒绝或DSA禁忌症,所有患者均进行了术后ivACT。结果:12例患者动脉瘤夹闭几乎完全,1例患者动脉瘤夹闭不完全,经ivACT诊断,术后行数字减影血管造影(DSA)确认,明确术后表现后患者接受。结论:本研究说明了ivACT对手术治疗动脉瘤术后控制的疗效。ivACT生成的图像质量似乎足以检测剪切后的残余动脉瘤。如果结果不确定,术后应进行DSA以获得进一步的细节。
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Central European Neurosurgery
Central European Neurosurgery CLINICAL NEUROLOGY-NEUROSCIENCES
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