Grüter, Basil E; Catalano, Kristina; Anon, Javier; Gruber, Philipp; Thanabalasingam, Arjun; Andereggen, Lukas; Schubert, Gerrit A; Remonda, Luca; Marbacher, Serge (2024). Intra-aneurysmal contrast agent stasis during intraoperative digital subtraction angiography may predict long-term occlusion after clipping. Acta neurochirurgica, 166(1), p. 309. Springer Nature 10.1007/s00701-024-06162-3
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PURPOSE
The routine use of intraoperative digital subtraction angiography (iDSA) increases detection of intracranial aneurysm (IA) remnants after microsurgical clipping. Spontaneous thrombosis of IA remnants after clipping is considered a rare phenomenon. We analyse iDSA characteristics to find predictors for IA remnant thrombosis.
METHODS
IA with intraoperative detection of a remnant after clipping were identified and divided into remnants experiencing spontaneous thrombosis, and remnants with long-term patency and/or remnant growth. Angiographic features of iDSA were analysed and compared between the two groups.
RESULTS
Of 37 IAs with intraoperative remnant on 3D-iDSA, five sustained a spontaneous remnant thrombosis and remained occluded in long-term follow-up. In all five cases, iDSA revealed delayed inflow and consequent stasis of the contrast agent until the late venous phase. On the other hand, in all cases with persistent long-term IA remnants (n = 32) iDSA demonstrated timely arterial contrast inflow and wash-out without stasis of intra-aneurysmal contrast agent.
CONCLUSIONS
Contrast stasis in IA remnants during iDSA appears to predict long-term IA occlusion, indicating that clip correction manoeuvres or even attempted endovascular treatment of the remnant IA may be avoided in these patients.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery |
UniBE Contributor: |
Andereggen, Lukas, Marbacher, Serge |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0942-0940 |
Publisher: |
Springer Nature |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
31 Jul 2024 16:55 |
Last Modified: |
31 Jul 2024 17:05 |
Publisher DOI: |
10.1007/s00701-024-06162-3 |
PubMed ID: |
39078422 |
Uncontrolled Keywords: |
Intracranial aneurysm Intraoperative DSA Occlusion Remnant Spontaneous Thrombosis |
BORIS DOI: |
10.48350/199404 |
URI: |
https://boris.unibe.ch/id/eprint/199404 |
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