RT Journal Article
SR Electronic
T1 A DSA-Based Method Using Contrast-Motion Estimation for the Assessment of the Intra-Aneurysmal Flow Changes Induced by Flow-Diverter Stents
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 808
OP 815
DO 10.3174/ajnr.A3322
VO 34
IS 4
A1 V.M. Pereira
A1 O. Bonnefous
A1 R. Ouared
A1 O. Brina
A1 J. Stawiaski
A1 H. Aerts
A1 D. Ruijters
A1 A.P. Narata
A1 P. Bijlenga
A1 K. Schaller
A1 K.-O. Lovblad
YR 2013
UL http://www.ajnr.org/content/34/4/808.abstract
AB BACKGROUND AND PURPOSE: Flow-diverter stents modify intra-aneurysmal blood flow and induce the progressive thrombosis of intracranial aneurysms followed by stable vascular reconstruction. The aim of this study was to report a new method for the appraisal of intracranial blood flow from DSA performed during endovascular treatment procedures. MATERIALS AND METHODS: A cohort of 24 patients with unruptured IAs who underwent FDS implantation was prospectively recruited. Pre- and post-DSA sequences in combination with 3D rotational angiography were acquired. The quantification of arterial and intra-aneurysmal flow was accomplished by using an optical flow approach. Flow reduction was assessed by using a new metric termed the mean aneurysm flow amplitude ratio. The correlation between the MAFA ratio and the incidence of aneurysm thrombosis was assessed by using receiver operating characteristic analysis and the Fisher exact test when the optimum Youden index was found. RESULTS: The quantification of flow was successfully achieved in 21 of 24 patients (87.5%). On the imaging follow-up, 18 aneurysms developed complete thrombosis (87.5%) and 3 displayed residual circulation (12.5%). The threshold analysis of the MAFA ratio significantly predicted thrombosis at 12 months below a threshold of 1.03 (P = .035). There was no significant correlation between the time for complete occlusion of the aneurysm and contrast stagnation inside the aneurysm after treatment (P > .05). CONCLUSIONS: The MAFA ratio based on DSA flow quantification appears to be a reliable predictor for the assessment of stent treatment outcomes in this small study. These results open the door for perioperative flow quantification and provide indices that may help clinicians make appropriate intraprocedural decisions. CAcontrast agent3DRA3D rotational angiographyFDSflow-diverter stentIAsintracranial aneurysmsMAFAmean aneurysm flow amplitudeOFoptical flow