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OtherINTERVENTIONAL

Flat Panel Detector Angiographic CT in the Management of Aneurysmal Rupture During Coil Embolization

T. Engelhorn, T. Struffert, G. Richter, M. Doelken, O. Ganslandt, W. Kalender and A. Doerfler
American Journal of Neuroradiology September 2008, 29 (8) 1581-1584; DOI: https://doi.org/10.3174/ajnr.A1119
T. Engelhorn
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T. Struffert
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G. Richter
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M. Doelken
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O. Ganslandt
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W. Kalender
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A. Doerfler
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    Fig 1.

    Patient 1. A, Initial axial CT scan before coil embolization shows only slight subarachnoid hemorrhage without intraparenchymal bleeding. B, Axial ACT scan reveals rebleeding mainly in the anterior interhemispheric gap and in the left frontal lobe before the onset of diagnostic angiography. C, Axial ACT scan after aneurysmal rupture and installation of the first 2 coils demonstrates no significant space-occupying rebleeding compared with initial ACT. D, Axial CT scan after coil embolization shows only subtle additional subarachnoid hemorrhage compared with intraprocedural ACT (C). E, Right internal carotid artery (ICA) arteriogram (anterior-posterior [AP] projection) reveals an anterior communicating artery aneurysm. F, Right ICA arteriogram (AP projection) demonstrates massive extravasation of contrast media before onset of endovascular therapy. G and H, Right ICA arteriogram (AP projection) and rotational 3D angiography show complete embolization after installation of 8 Guglielmi detachable coils.

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    Fig 2.

    Patient 2. A, Axial CT scan before onset of endovascular treatment. B, After postprocessing, MPRs in axial orientation parallel to the skull base identical to conventional CT were calculated. C, Axial ACT scan (preprocedural) reveals no rebleeding in the time between conventional CT and onset of angiography. D, Axial ACT scan (intraprocedural) after aneurysmal rupture and installation of 2 coils shows no significant increase in subarachnoid hemorrhage compared with preprocedural ACT. E, Axial CT scan after endovascular treatment shows no rebleeding after installation of the first 2 coils. F, Rotational 3D angiography shows an irregular, lobulated basilar tip aneurysm. G and H, Basilar artery arteriogram (lateral projection) demonstrates slight extravasation of contrast media (arrow) after installation of the first coil. I, Basilar artery arteriogram (AP projection) shows complete embolization after installation of 7 coils.

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American Journal of Neuroradiology: 29 (8)
American Journal of Neuroradiology
Vol. 29, Issue 8
September 2008
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Flat Panel Detector Angiographic CT in the Management of Aneurysmal Rupture During Coil Embolization
T. Engelhorn, T. Struffert, G. Richter, M. Doelken, O. Ganslandt, W. Kalender, A. Doerfler
American Journal of Neuroradiology Sep 2008, 29 (8) 1581-1584; DOI: 10.3174/ajnr.A1119

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Flat Panel Detector Angiographic CT in the Management of Aneurysmal Rupture During Coil Embolization
T. Engelhorn, T. Struffert, G. Richter, M. Doelken, O. Ganslandt, W. Kalender, A. Doerfler
American Journal of Neuroradiology Sep 2008, 29 (8) 1581-1584; DOI: 10.3174/ajnr.A1119
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