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Setlur Nagesh SV, Vakharia K, Waqas M, Munich SA, Bednarek DR, Davies JM, Snyder KV, Mokin M, Rudin S, Levy EI, Siddiqui AH. Single-center experience of using high definition (Hi-Def) imaging during neurointervention treatment of intracranial aneurysms using flow diverters. J Neurointerv Surg 2020; 12:897-901. [PMID: 32046993 DOI: 10.1136/neurintsurg-2019-015551] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/19/2019] [Accepted: 01/05/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND A new dual resolution imaging x-ray detector system (Canon Medical Systems Corporation, Tochigi, Japan) has a standard resolution 194 µm pixel conventional flat-panel detector (FPD) mode and a high-resolution 76 µm high-definition (Hi-Def) mode in a single unit. The Hi-Def mode enhances the visualization of the intravascular devices. OBJECTIVE We report the clinical experience and physician evaluation of this new detector system with Hi-Def mode for the treatment of intracranial aneurysms using a Pipeline embolization device (PED). METHODS During intervention at our institute, under large field of view (FOV) regular resolution FPD mode imaging, the catheter systems and devices were first guided to the proximity of the treatment area. Final placement and deployment of the PED was performed under Hi-Def mode guidance. A post-procedure 9-question physician survey was conducted to qualitatively assess the impact of Hi-Def mode visualization on physicians' intraoperative decision-making. One-sample t-test was performed on the responses from the survey. Dose values reported by the x-ray unit were also recorded. RESULTS Twenty-five cases were included in our study. The survey results indicated that, for each of the nine questions, the physicians in all cases indicated that the Hi-Def mode improved visualization compared with the FPD mode. For the 25 cases, the mean cumulative entrance air kerma was 2.35 Gy, the mean dose area product (DAP) was 173.71 Gy.cm2, and the mean x-ray exposure time was 39.30 min. CONCLUSIONS The Hi-Def mode improves visualization of flow diverters and may help in achieving more accurate placement and deployment of devices.
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Affiliation(s)
- Swetadri Vasan Setlur Nagesh
- Canon Stroke and Vascular Research Center, UB Neurosurgery, University at Buffalo, State University of New York, Buffalo, New York, USA.,Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States
| | - Kunal Vakharia
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, United States
| | - Muhammad Waqas
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, United States
| | - Stephan A Munich
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, United States
| | - Daniel R Bednarek
- Canon Stroke and Vascular Research Center, UB Neurosurgery, University at Buffalo, State University of New York, Buffalo, New York, USA.,Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States.,Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States
| | - Jason M Davies
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, United States.,Department of Bioinformatics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, New York, United States
| | - Kenneth V Snyder
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, United States
| | - Maxim Mokin
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, United States
| | - Stephen Rudin
- Canon Stroke and Vascular Research Center, UB Neurosurgery, University at Buffalo, State University of New York, Buffalo, New York, USA.,Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States.,Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States.,Department of Biomedical Engineering, University at Buffalo, Buffalo, New York, United States.,Department of Mechanical and Aerospace Engineering, University at Buffalo, Buffalo, New York, United States.,Department of Electrical Engineering, University at Buffalo, Buffalo, New York, United States
| | - Elad I Levy
- Canon Stroke and Vascular Research Center, UB Neurosurgery, University at Buffalo, State University of New York, Buffalo, New York, USA.,Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, United States.,Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States
| | - Adnan H Siddiqui
- Canon Stroke and Vascular Research Center, UB Neurosurgery, University at Buffalo, State University of New York, Buffalo, New York, USA .,Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, United States.,Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States
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