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AJNR - American Journal of Neuroradiology

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Stent-Assisted Coiling of Intracranial Aneurysms Aided by Virtual Parent Artery Reconstruction

Christof Karmonik^a, Charles M. Strother^a, Xiaoyan Chen^c, Frank Deinzer^c, Richard Klucznik^b and Michel E. Mawad^a,b

^a Department of Radiology, Baylor College of Medicine, Houston, TX
^b Department of Radiology, The Methodist Hospital, Houston, TX
^c Siemens Medical Systems, Erlangen, Germany

View larger version (78K): [in a new window]   FIG 1. (A) 2D-DSA pretreatment projection images (left: AP view, center: lateral view) and 3D-DSA surface volume reconstruction (right) for case 1. (B) Virtual artery reconstruction (left: selected cut-plane section; center: cut-surface volume reconstruction; right: 3D-DSA surface volume reconstruction). The blue circles mark the location of the virtual artery in each picture. The green arrows depict "pockets" or cul-de-sacs around the virtually reconstructed artery. (C) 2D-DSA posttreatment projection images (left: AP view; right: lateral view). Coil loops in the "pocket" along the medial side of the aneurysm appear to lie within the parent artery. Comparison with the cut-plane section and the cut-surface reconstruction in (B); however, show that they are actually located outside the stent.

View larger version (81K): [in a new window]   FIG 2. (A) 2D-DSA pretreatment projection images (left: AP view; right: lateral view) for case 2. (B) Virtual artery reconstruction (left: selected cut-plane section; right: cut-surface volume reconstruction). The blue circles mark the position of the virtual artery. The green arrows demonstrate the extension of the aneurysm ostium posterior to the boundary of the parent artery. (C) 2D posttreatment projection images (left: DSA AP view; center: DSA lateral view; right: native lateral view). Red arrows depict coils that appear to be within the parent artery.