Postoperative 3D Angiography in Intracranial Aneurysms
Hyun-Seung Kanga,
Moon Hee Hana,c,d,
Bae Ju Kwona,
Sung Il Junga,
Chang-Wan Ohb,
Dae Hee Hanb and
Kee-Hyun Changa,c,d
a Department of Radiology, Seoul National University College of Medicine, Korea
b Department of Neurosurgery, Seoul National University College of Medicine, Korea
c Clinical Research Institute, Seoul National University Hospital, Korea
d Institute of Radiation Medicine, SNUMRC, Korea
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FIG 1. Case 21. Large residual aneurysm.
A and B, Postoperative DSA image (A) and 3D angiogram (B) obtained 6 months after surgery for a posterior communicating artery aneurysm shows residual aneurysm.
C, Posterior 3D angiogram reveals the relationship of the clip, residual aneurysm, posterior communicating artery, and anterior choroidal artery.
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FIG 2. Small, dog-eared remnant aneurysm.
A—C, Case 24. Postoperative DSA (A) performed 8 days after surgery for anterior and posterior communicating artery aneurysms shows no residual. Anterior 3D angiogram (B) shows the vessels and clips in the two aneurysms well. Posterior 3D angiogram (C) reveals a tiny, dog-ear remnant in the anterior communicating artery region (arrow).
D–F, Case 5. Postoperative DSA (D) of a clipped anterior communicating artery aneurysm shows no definite residual. Anterior oblique and posterior oblique 3D aneurysms (E, F) reveal a residual aneurysm near the ends of the clips and its relationship with a fenestration.
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FIG 3. Case 47. Giant aneurysm of the ICA.
A and B, Anterior and posterior 3D angiograms show the aneurysm in the supraclinoid region, displacing the anterior cerebral artery upward.
C, Section through the aneurysm neck shows its broad nature.
D, Postoperative DSA shows well-reconstructed ICA and small residue in the proximal part of the aneurysm.
E and F, Anterior and inferior postoperative 3D angiograms reveal seven clips, without artifact, used for reconstruction of the ICA and proximal residual aneurysm.
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FIG 4. Case 65. Dolichocarotid aneurysms.
A–C, Anterior and posterior preoperative DSA and 3D angiographic views show a complex aneurysms involving the distal ICA.
D, On postoperative DSA, it is hard to see which part of the aneurysms is clipped.
E and F, Anterior and posterior 3D angiograms reveal that the lateral part of the aneurysms is clipped, and part of ICA is included within the end of the clip.
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