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Toader C, Covache-Busuioc RA, Bratu BG, Corlatescu AD, Popa AA, Ciurea AV. Kissing Aneurysms of the Anterior Communicating Artery Treated With Surgical Clipping: A Case Report and Literature Review. Cureus 2024; 16:e60824. [PMID: 38910700 PMCID: PMC11190632 DOI: 10.7759/cureus.60824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2024] [Indexed: 06/25/2024] Open
Abstract
Intracranial "kissing" aneurysms are rare vascular conditions described as two anatomically adjacent aneurysms originating from either the same or different arteries, with their walls pressed together. Two-dimensional angiography was formerly considered the gold standard for diagnosis, with the three-dimensional rotational type now offering more insightful details about vascular discrepancies. The treatment of anterior communicating artery (AcoA) "kissing" aneurysms poses significant challenges, with surgical clipping proving difficult due to their deep midline location or the bilateral anterograde arterial supply. However, advancements in endovascular coil embolization, such as dual-volume reconstruction, can assist in diagnosis. This study presents the case of a 50-year-old patient who was diagnosed with "kissing" aneurysms of the AcoA. The patient underwent surgical clipping and showed no pathological follow-up findings. The surgical intervention often provides a more direct and effective approach. This case contributes to the body of knowledge surrounding the management of this complex disease.
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Affiliation(s)
- Corneliu Toader
- Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, ROU
- Department of Neurosurgery, National Institute of Neurology and Neurovascular Diseases, Bucharest, ROU
| | | | - Bogdan-Gabriel Bratu
- Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, ROU
| | | | - Andrei Adrian Popa
- Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, ROU
| | - Alexandru Vladimir Ciurea
- Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, ROU
- Department of Neurosurgery, Sanador Clinical Hospital, Bucharest, ROU
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Ki HJ, Kim BS, Kim JK, Choi JH, Shin YS, Choi Y, Shin NY, Jang J, Ahn KJ. Low-Dose Three-Dimensional Rotational Angiography for Evaluating Intracranial Aneurysms: Analysis of Image Quality and Radiation Dose. Korean J Radiol 2022; 23:256-263. [PMID: 35029071 PMCID: PMC8814704 DOI: 10.3348/kjr.2021.0162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 11/25/2022] Open
Abstract
Objective This study aimed to evaluate the image quality and dose reduction of low-dose three-dimensional (3D) rotational angiography (RA) for evaluating intracranial aneurysms. Materials and Methods We retrospectively evaluated the clinical data and 3D RA datasets obtained from 146 prospectively registered patients (male:female, 46:100; median age, 58 years; range, 19–81 years). The subjective image quality of 79 examinations obtained from a conventional method and 67 examinations obtained from a low-dose (5-seconds and 0.10-µGy/frame) method was assessed by two neurointerventionists using a 3-point scale for four evaluation criteria. The total image quality score was then obtained as the average of the four scores. The image quality scores were compared between the two methods using a noninferiority statistical testing, with a margin of -0.2 (i.e., score of low-dose group – score of conventional group). For the evaluation of dose reduction, dose-area product (DAP) and air kerma (AK) were analyzed and compared between the two groups. Results The mean total image quality score ± standard deviation of the 3D RA was 2.97 ± 0.17 by reader 1 and 2.95 ± 0.20 by reader 2 for conventional group and 2.92 ± 0.30 and 2.95 ± 0.22, respectively, for low-dose group. The image quality of the 3D RA in the low-dose group was not inferior to that of the conventional group according to the total image quality score as well as individual scores for the four criteria in both readers. The mean DAP and AK per rotation were 5.87 Gy-cm2 and 0.56 Gy, respectively, in the conventional group, and 1.32 Gy-cm2 (p < 0.001) and 0.17 Gy (p < 0.001), respectively, in the low-dose group. Conclusion Low-dose 3D RA was not inferior in image quality and reduced the radiation dose by 70%–77% compared to the conventional 3D RA in evaluating intracranial aneurysms.
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Affiliation(s)
- Hee Jong Ki
- Department of Neurosurgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Bum-Soo Kim
- Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
| | - Jun-Ki Kim
- Department of Neurosurgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Jai Ho Choi
- Department of Neurosurgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Yong Sam Shin
- Department of Neurosurgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Yangsean Choi
- Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Na-Young Shin
- Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Jinhee Jang
- Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Kook-Jin Ahn
- Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
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Li B, Zhuo J, Song G, Zhang J, Zhao W, Zhao Z, Wang L, Dong Y, Zhang X, Zhang G. Single-Center Analysis of Reliability of 3D-DSA Dual Volume Reconstruction for Evaluation of Endovascularly Treated Intracranial Aneurysms. World Neurosurg 2021; 155:e150-e155. [PMID: 34454070 DOI: 10.1016/j.wneu.2021.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To explore the applications of 3-dimensional digital subtraction angiography (3D-DSA) double-volume reconstruction technique (DVRT) in endovascular embolization for the treatment of intracranial aneurysm. METHODS A cohort of 112 patients with a total of 127 intracranial aneurysms admitted to the neurosurgery department from June 2018 to October 2019 were selected. Cerebrovascular angiographies were performed after admission. Patients were divided into observation group (56 of 112) and control group (56 of 112) randomly when endovascular embolization was performed. Individuals in the control group were treated with 2D-DSA technique, and patients in the observation group were treated with 3D-DSA DVRT. The Raymond method was used to determine the degree of embolism. RESULTS There was no significant difference in sex, blood pressure, cerebral atherosclerosis, aneurysm site or size, contrast agent dosage, x-ray dose, or surgical cost between the 2 groups. There was no postoperative recurrence in the observation group. However, the recurrence rate in the control group is 10.7% (6 of 56). Postoperative thrombosis occurred in 1 case (1 of 56, 1.8%) in the observation group and 7 cases (7 of 56, 12.5%) in the control group. No postoperative cerebral infarction was recorded in the observation group, while 5 cases (8.9%, 5 of 56) in the control group presented with postoperative cerebral infarction. CONCLUSIONS 3D-DVRT for intracranial aneurysm embolization provides the best working angle, clearly shows the process of aneurysm embolization and its relationship with peripheral vessels, and reduces the occurrence of surgical complications including postoperative recurrence, thrombosis, and cerebral infarction.
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Affiliation(s)
- Bo Li
- Department of Neurosurgery, Affiliated Hospital of Jining Medical University, Jining, Shandong, PR China
| | - Jun Zhuo
- Department of Interventional Radiology, Affiliated Hospital of Jining Medical University, Jining, Shandong, PR China
| | - Guohong Song
- Department of Neurosurgery, Affiliated Hospital of Jining Medical University, Jining, Shandong, PR China
| | - Junchen Zhang
- Department of Neurosurgery, Affiliated Hospital of Jining Medical University, Jining, Shandong, PR China
| | - Wanju Zhao
- Department of Neurosurgery, Affiliated Hospital of Jining Medical University, Jining, Shandong, PR China
| | - Zhongqing Zhao
- Department of Interventional Radiology, Affiliated Hospital of Jining Medical University, Jining, Shandong, PR China
| | - Lin Wang
- Department of Interventional Radiology, Affiliated Hospital of Jining Medical University, Jining, Shandong, PR China
| | - Yan Dong
- Department of Interventional Radiology, Affiliated Hospital of Jining Medical University, Jining, Shandong, PR China
| | - Xiang Zhang
- Department of Interventional Radiology, Affiliated Hospital of Jining Medical University, Jining, Shandong, PR China
| | - Guangning Zhang
- Department of Neurosurgery, Affiliated Hospital of Jining Medical University, Jining, Shandong, PR China.
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Abdel Samad AM, Ibrahim YA, Othman AIA. Added value of three-dimensional digital subtraction angiography, using dual-volume reconstruction technique, in post-treatment follow-up of cerebral aneurysms. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2019. [DOI: 10.1186/s43055-019-0037-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To assess the added value of the dual-volume technique when used with the routine single-volume 3D DSA in the follow-up of endovascularly treated aneurysms.
Results
Seventeen patients (10 females and 7 males) who underwent coiling of their cerebral aneurysms were assessed by 3D DSA using single- and dual-volume techniques. Recanalization of the aneurysm was depicted in 10 cases on the dual-volume technique, only 4 of which were detected on the single-volume 3D DSA technique. Thus, the use of the dual-volume technique upgraded our management plan from follow-up to re-treatment in 6 cases (35%)
Conclusion
The dual-volume technique of 3D DSA is superior to the single-volume technique in visualization of the endovascular devices distinctly, resulting in better evaluation of the aneurysm recanalization and its relation to the parent vessel and occluding device.
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Kim YI, Lee DH, Cho CB, Yang SH, Kim IS, Hong JT, Sung JH, Jeun SS. The Usefulness of Dual-Volume Visualization (Three-Dimensional Digital Subtraction Angiography and Cross-Sectional Imaging) for Surgical Planning in Treating Intracranial Meningiomas: A Case Series and Technical Report. World Neurosurg 2019; 122:e59-e66. [DOI: 10.1016/j.wneu.2018.09.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 09/05/2018] [Accepted: 09/07/2018] [Indexed: 11/30/2022]
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