Users online: 48  Small font sizeDefault font sizeIncrease font size Print this article Email this article
Search Again
 Back
 Table of Contents
 
 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Article Access Statistics
 Reader Comments
 Email Alert
 Add to My List
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed2031    
    Printed174    
    Emailed0    
    PDF Downloaded453    
    Comments [Add]    
    Cited by others 4    

Recommend this journal

 
ORIGINAL ARTICLE
Year : 2011  |  Volume : 2  |  Issue : 1  |  Page : 134

"Real-world" comparison of non-invasive imaging to conventional catheter angiography in the diagnosis of cerebral aneurysms


1 Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
2 Department of Neurological Surgery, School of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA

Correspondence Address:
Robert A Mericle
Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN
USA
Login to access the Email id

© 2011 Tomycz et al; This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


DOI: 10.4103/2152-7806.85607

PMID: 22059129

Get Permissions

Background : Based on numerous reports citing high sensitivity and specificity of non-invasive imaging [e.g. computed tomography angiography (CTA) or magnetic resonance angiography (MRA)] in the detection of intracranial aneurysms, it has become increasingly difficult to justify the role of conventional angiography [digital subtraction angiography (DSA)] for diagnostic purposes. The current literature, however, largely fails to demonstrate the practical application of these technologies within the context of a "real-world" neurosurgical practice. We sought to determine the proportion of patients for whom the additional information gleaned from 3D rotational DSA (3DRA) led to a change in treatment. Methods : We analyzed the medical records of the last 361 consecutive patients referred to a neurosurgeon at our institution for evaluation of "possible intracranial aneurysm" or subarachnoid hemorrhage (SAH). Only those who underwent non-invasive vascular imaging within 3 months prior to DSA were included in the study. For asymptomatic patients without a history of SAH, aneurysms less than 5 mm were followed conservatively. Treatment was advocated for patients with unruptured, non-cavernous aneurysms measuring 5 mm or larger and for any non-cavernous aneurysm in the setting of acute SAH. Results : For those who underwent CTA or MRA, the treatment plan was changed in 17/90 (18.9%) and 22/73 (30.1%), respectively, based on subsequent information gleaned from DSA. Several reasons exist for the change in the treatment plan, including size and location discrepancies (e.g. cavernous versus supraclinoid), or detection of a benign vascular variant rather than a true aneurysm. Conclusions : In a "real-world" analysis of intracranial aneurysms, DSA continues to play an important role in determining the optimal management strategy.



[FULL TEXT] [PDF]*

        

Print this article         Email this article