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  • The Utility of Dual-Energy Computed Tomographic Angiography for the Evaluation of Brain Aneurysms After Endovascular Coiling: A Prospective Study

    Final Number:

    Parviz Dolati-Ardejani MD; Ajith J. Thomas MD; Daniel Green Eichberg MD; Suresh A Reddy MD; Christopher S. Ogilvy MD

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2016 Annual Meeting

    Introduction: The purpose of this prospective study was to compare a novel dual-energy CTA (DECTA) method for postoperative assessment of coiled brain aneurysms to detect aneurysm recanalization and patency of adjacent blood vessels, with catheter-based digital subtraction angiography (DSA).

    Methods: Patients who underwent endovascular cerebral aneurysm coiling were prospectively evaluated postoperatively by both DECTA and conventional DSA. CTA was performed using a novel dual-energy method with single source and fast kilovoltage switching. DSA was performed using biplanar cerebral angiography. An experienced neuroradiologist and neurosurgeon both blinded to the original radiological results reviewed the images.

    Results: Fifty-four patients (38 female and 16 male, average age 47.6+9) with 55-coiled aneurysms were enrolled in our study between July 2014 and June 2015. Twenty-nine patients suffered a subarachnoid hemorrhage (SAH), and 26 patients had an incidentally found cerebral aneurysm. All patients had at least one DSA and DECTA performed at most one week apart from each other. DECTA showed a 100% sensitivity and specificity in detection of complete aneurysm occlusion and 80% sensitivity and specificity for detection of residual necks and domes. DECTA successfully detected all vascular diameter changes as comparable as DSA with minimal interfering artifact.

    Conclusions: Dual energy CTA is a promising non-invasive alternative to conventional catheter-based angiography for identification of aneurysm recurrence and assessment of adjacent arteries following endovascular coiling. It allows for far more rapid image acquisition than DSA, non-invasive and is widely available at clinical centers.

    Patient Care: By preventing unnecessary invasive follow up images, we can decrease the risk of stroke, radiation and save money and human efforts.

    Learning Objectives: -Understanding the role of Dual energy CTA in evaluation of coiled aneurysm. -How we can we prevent unnecessary invasive follow up images like cerebral catheter angiography with non-invasive images after coiling an aneurysm

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