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  • Assessment of Residual Flow by 3D Time-of-flight MR Angiography After Stent-assisted Coiling for Intracranial Aneurysms

    Final Number:

    Sei Sugata MD, PhD

    Study Design:

    Subject Category:
    Aneurysm/Subarachnoid Hemorrhage

    Meeting: AANS/CNS Cerebrovascular Section 2016 Annual Meeting

    Introduction: Stent-assisted coiling (SAC) for intracranial aneurysms requires adequate follow-up imaging because of recurrence and thromboembolic events after the treatment. Residual flow in coiled aneurysms or patency of the stents are difficult to visualize by usual MR angiography (MRA) due to metal artifact. We applied 3D time-of-flight (TOF) MRA characterized by a short TE (1.69 ms) and a high spatial resolution to diminish metal artifact.

    Methods: We assessed the hypothesis that 3D TOF MRA could accurately visualize residual flow in coiled aneurysms and blood flow in placed stent after SAC. From January 2011 to June 2014, 35 patients (29 females, mean age; 66.2 years, 10 ruptured cases) were treated with SAC, using Enterprise® for 22 cases and Neuroform EZ® (NFEZ) for 13 cases. We compared postprocedual 3D TOF MRA images with concurrent digital subtraction angiography (DSA) images after SAC.

    Results: 3D TOF MRA visualized parent arteries at placed stents in 12 cases (34.2%), and residual flow in coiled aneurysms in 17 cases (48.6%). Volume embolization rate (P < 0.01) and type of stent (P < 0.001) significantly affected the visualization of residual flow in coiled aneurysms. Particularly, in 12 out of 13 cases (92.3%) with NFEZ, 3D TOF MRA images demonstrated residual lumen and patency of the parent artery equivalent to DSA images.

    Conclusions: 3D TOF MRA could provide acceptable visualization of both parent artery lumen and residual sac, especially in the cases with Neuroform EZ®.

    Patient Care: 3D TOF MRA could accurately visualize residual flow in coiled aneurysms and blood flow in placed stent after stent-assisted coiling.

    Learning Objectives: By the conclusion of this session, participants should be able to identify an usefull assessment after stent-assisted coiling for intracranial aneurysms.


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