Metallic Artifice Reduction Angio Tomography versus Digital Subtraction Angiography for the Evaluation of Occlusion of Intracranial Aneurysms after Endovascular Management
Sara Sofia Checa*, Luis Felipe Checa, Jesus Alberto Morales and Angel Martinez-Ponce de Leon
Abstract
Objective: To compare the accuracy of metallic artifice reduction Angiotomography (CTAMaR) and digital subtraction angiography (DSA) for the evaluation of occlusion of intracranial aneurysms after endovascular management with coils.
Background: Intracranial aneurysms affect about 2% of the general population. Endovascular embolization with coils is used to treat acute subarachnoid hemorrhage and unruptured aneurysms. Image follow-up is necessary and the DSA has been considered the “gold standard”. Over time, time-of-flight MRA and other alternative techniques will replace DSA. In some cases, MRA is not an option, so (CTAMaR) is considered as a viable alternative for monitoring coil-embolized aneurysms.
Methods: Retrospective study in patients with intracranial aneurysms treated by coil embolization at the José Eleuterio González University Hospital (HU) in 2018 and 2019, who underwent CTAMaR and DSA for follow-up after embolization. The images were independently analyzed by two Neuroradiologists and two Endovascular Neurosurgeons. The observers agreed and K statistics were used to calculate the Cohen coefficient.
Results: 66 patients were treated in 62 coil embolizations between 2018 and 2019. After the exclusions, 12 image pairs formed the study group. In 92% of the compared images, the results of the CTARAM and
the DSA coincided. The sensitivity and specificity of the CTARAM were calculated, which were respectively 100% and 75%.
Conclusion: This study suggests that CTAMaR is a safe and valuable method for monitoring coil-embolized cerebral aneurysms. This technique is as accurate as DSA in the evaluation and detection of recanalization of coil-embolized aneurysms.