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Clin Neuroradiol. 2014 Mar;24(1):43-9. doi: 10.1007/s00062-013-0224-z. Epub 2013 May 28.

Angiographic C-arm CT visualization of the Woven EndoBridge cerebral aneurysm embolization device (WEB): first experience in an animal aneurysm model.

Author information

1
Department of Neuroradiology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany, tobias.struffert@uk-erlangen.de.

Abstract

INTRODUCTION:

Improvements in the imaging capabilities of angiographic C-arm computed tomography (CT) using flat detector angiographic (FD-CT) systems now provide a means for the in vivo visualization of devices used for the treatment of intracranial aneurysms. One such device, the WEB embolization device, is made of a braided mesh of nitinol wires, the size of which are near to the limits of visualization using conventional x-ray fluoroscopy. Our hypothesis was that the imaging of these implants C-arm CT would provide useful information regarding their positioning and deployment.

METHODS:

In five New Zealand white rabbits elastase induced aneurysms were created and subsequently treated using a WEB. Imaging was performed using digital subtraction angiography (DSA), X-ray imaging and two different Angiographic C-arm CT protocols. The images were evaluated by two neuroradiologists using an evaluation scale.

RESULTS:

The mesh of the WEB was barely visible on the DSA or x-ray fluoroscopy images. Volume rendering technique (VRT) reconstruction and multiplanar reconstruction (MPR) of images done using the C-arm CT protocols clearly delineated the shape and structure of the device. Contrast-enhanced MPR and VRT reconstructions allowed assessment of the status of blood flow in the aneurysms. Beam hardening artifacts caused by platinum markers on the WEB were present.

CONCLUSION:

In vivo C-arm CT imaging of the WEB is feasible and allows precise determination of the position and deployment status of the device. On contrast-enhanced images the occlusion status of aneurysms and the positioning of the WEB in relationship to the parent artery can be evaluated. C-arm-CT may serve as a minimal-invasive follow-up imaging modality.

PMID:
23712863
DOI:
10.1007/s00062-013-0224-z
[Indexed for MEDLINE]

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