Article Figures & Data
Figures
- Fig 1.
Schematic drawings show measurement of aneurysmal diameters in aneurysms with simple and complex shapes.
A, An aneurysm with simple shape (oval with a small bleb). Neck size (a) used in this study is the largest axial diameter of the orifice of the aneurysm. Dome size used for the dome-to-neck ratio is a short axial diameter of the dome (b). Estimation of the maximum diameter of the sac is shown (c). The small bleb is not included when estimating the maximal diameter of the sac.
B, Aneurysm with complex shape (multilobular). Dome size used for the dome-to-neck ratio in this type is the short axial diameter of the proximal dome (b).
- Fig 2.
Ruptured internal carotid artery aneurysm.
A, Lateral 2D-DSA image. A wide-necked aneurysm can be seen at the origin of the posterior communicating artery (arrows). The relationship of the aneurysm to the posterior communicating artery is not clear in this image.
B, Surface shaded display image. Note the neck of the aneurysm and its involvement with the posterior communicating artery (arrows). The dome-to-neck ratio is 1.0 on this three-dimensional image. The calculated difficulty score is 3.
C, GDC procedure was performed with a double microcatheter (arrowheads) technique.
D, Lateral 2D-DSA image obtained immediately after GDC procedure shows incomplete occlusion (<95%) of the aneurysm and patent posterior communicating artery (arrows).
- Fig 3.
Ruptured aneurysm of the anterior communicating artery.
A, Right anterior oblique 2D-DSA shows aneurysm of the anterior communication artery with a dome-to-neck ratio of 1.8. A small perforating artery (arrows) is thought to originate from the aneurysmal dome.
B, MIP image of the 3D-DSA image shows aneurysm of the anterior communication artery with a dome-to-neck ratio of 1.8. A small perforating artery (arrows) is thought to originate from the aneurysmal dome.
C, Posterior surface shaded display image clearly shows that the perforating artery originates from the anterior cerebral artery (arrowheads), beyond the neck and running along the aneurysmal sac. Difficulty score is 0.
D, Right anterior oblique 2D-DSA image obtained immediately after the GDC procedure shows complete occlusion (100%) of the aneurysm with a patent perforating artery (arrows).
Tables
Morphologic Factors of Aneurysms Based on 3D Digital Subtraction Angiography No. of Aneurysms in Each Occlusion Rate Totals (n=47) 100% (n=20) ≧95% (n = 11) <95% (n=16) Largest diameter Small (<5 mm) 13 4 7 25 Medium (≧5 mm) 7 7 9 22 Neck size Small (<4 mm) 17 10 12 39 Wide (≧4 mm) 3 1 4 8 Shape Simple 19 8 11 38 Complex 1 3 5 9 Dome-to-neck ratio <1.2 0 1 9 10 1.2–1.5 11 6 4 21 >1.5 9 4 3 16 Relationship to the major neighboring artery Separate 18 8 8 34 Involved 2 3 8 13 Neck Size Shape Dome-to-Neck Ratio Relationship to the Major Neighboring Artery Neck size 1.0 −0.119 −2.58 0.257 Shape 1.0 0.286 0.257 Dome-to-neck ratio 1.0 −0.055 Relationship to the major neighboring artery 1.0 Difficulty Score No. of Aneurysms in Each Occlusion Rate Totals (n=47) 100% (n=20) ≥95% (n = 11) <95% (n=16) 0 9 4 1 14 1 10 4 2 16 2 1 3 9 13 3 0 0 4 4
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