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Aneurysm Ostium Angle: A Predictor of the Need for Stent as Assistance for Endovascular Aneurysm Coiling in Internal Carotid Artery Sidewall Aneurysms

Aneurysm Ostium Angle: A Predictor of the Need for Stent as Assistance for Endovascular Aneurysm... This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A2515v1 32/7/1216 most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Yasuda, R. Articles by Mawad, M. E. PubMed PubMed Citation Articles by Yasuda, R. Articles by Mawad, M. E. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 32:1216-1220, August 2011 © 2011 American Society of Neuroradiology INTERVENTIONAL Aneurysm Ostium Angle: A Predictor of the Need for Stent as Assistance for Endovascular Aneurysm Coiling in Internal Carotid Artery Sidewall Aneurysms R. Yasuda a ,b , A. Arat a , C.M. Strother a , B. Aagaard-Kienitz a , D. Niemann a , A. Mohamed c , K. Royalty d , K. Pulfer a , W. Taki b and M.E. Mawad e a From the University of Wisconsin School of Medicine and Public Health (R.Y., A.A., C.M.S., B.A.-K., D.N., K.P.), Madison, Wisconsin b Mie University Graduate School of Medicine (R.Y., W.T.), Tsu, Mie, Japan c Siemens Japan K.K (A.M.), Tokyo, Japan d Siemens Medical Solutions (K.R.), Hoffman Estates, Illinois e Baylor College of Medicine, Department of Radiology (M.E.M.), Houston, Texas Please address correspondence to Charles M. Strother, MD, University of Wisconsin School of Medicine and Public Health, 1111 Highland Ave, WIMR Room 1318, Madison, WI 53705; e-mail: CStrother@uwhealth.org BACKGROUND AND PURPOSE: There is no satisfactory parameter that can predict the need for assistant devices for endovascular aneurysm coiling. Our aim was to evaluate the utility of MOA as a predictor of the need for stent-assisted coiling in ICA sidewall aneurysms. MATERIALS AND METHODS: From a retrospective review of an internal data base, 55 consecutive ICA sidewall aneurysms were identified. Thirty-two of the aneurysms were treated by using endovascular techniques. Because 23 of the 55 aneurysms were either untreated or clipped, 3 experienced interventionalists reviewed the 3D images of these aneurysms and then made a decision as to whether stent-assisted coiling would have been required. Thirty-one of the 55 aneurysms would have required stent-assisted coiling, while 24 would not. Neck width, DNR, AR, and MOA were obtained from each aneurysm by using prototype software. These parameters were then correlated with the requirement of stent-assisted coiling. RESULTS: MOA and neck width of aneurysms requiring stent-assisted coiling were significantly larger than those not requiring stent-assisted coiling ( P < .001 and <0.001, respectively). Although the DNR and AR of aneurysms requiring stent-assisted coiling were smaller than those not requiring it, the difference was not significant ( P = .22 and 0.12, respectively). ROC analysis revealed that MOA was the parameter that best correlated with the need for stent-assisted coiling. Inclusion of MOA with the rest of the parameters significantly increased the predictive performance regarding the need for stent-assisted coiling ( P = .005). CONCLUSIONS: In this small study, MOA was a useful parameter to predict the need for stent-assisted coiling in ICA sidewall aneurysms. Further prospective study of this parameter for aneurysms at multiple locations is required to determine its ultimate value. Abbreviations: AR, aspect ratio • AUC, area under the curve • CI, confidence interval • DNR, dome-to-neck ratio • DSA, digital subtraction angiography • ICA, internal carotid artery • MOA, maximum ostium angle • OphA, ophthalmic artery • PcomA, posterior communicating artery • ROC, receiver operating characteristic • SHA, superior hypophyseal artery Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2011 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Aneurysm Ostium Angle: A Predictor of the Need for Stent as Assistance for Endovascular Aneurysm Coiling in Internal Carotid Artery Sidewall Aneurysms

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Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2011 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A2515
Publisher site
See Article on Publisher Site

Abstract

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A2515v1 32/7/1216 most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Yasuda, R. Articles by Mawad, M. E. PubMed PubMed Citation Articles by Yasuda, R. Articles by Mawad, M. E. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 32:1216-1220, August 2011 © 2011 American Society of Neuroradiology INTERVENTIONAL Aneurysm Ostium Angle: A Predictor of the Need for Stent as Assistance for Endovascular Aneurysm Coiling in Internal Carotid Artery Sidewall Aneurysms R. Yasuda a ,b , A. Arat a , C.M. Strother a , B. Aagaard-Kienitz a , D. Niemann a , A. Mohamed c , K. Royalty d , K. Pulfer a , W. Taki b and M.E. Mawad e a From the University of Wisconsin School of Medicine and Public Health (R.Y., A.A., C.M.S., B.A.-K., D.N., K.P.), Madison, Wisconsin b Mie University Graduate School of Medicine (R.Y., W.T.), Tsu, Mie, Japan c Siemens Japan K.K (A.M.), Tokyo, Japan d Siemens Medical Solutions (K.R.), Hoffman Estates, Illinois e Baylor College of Medicine, Department of Radiology (M.E.M.), Houston, Texas Please address correspondence to Charles M. Strother, MD, University of Wisconsin School of Medicine and Public Health, 1111 Highland Ave, WIMR Room 1318, Madison, WI 53705; e-mail: CStrother@uwhealth.org BACKGROUND AND PURPOSE: There is no satisfactory parameter that can predict the need for assistant devices for endovascular aneurysm coiling. Our aim was to evaluate the utility of MOA as a predictor of the need for stent-assisted coiling in ICA sidewall aneurysms. MATERIALS AND METHODS: From a retrospective review of an internal data base, 55 consecutive ICA sidewall aneurysms were identified. Thirty-two of the aneurysms were treated by using endovascular techniques. Because 23 of the 55 aneurysms were either untreated or clipped, 3 experienced interventionalists reviewed the 3D images of these aneurysms and then made a decision as to whether stent-assisted coiling would have been required. Thirty-one of the 55 aneurysms would have required stent-assisted coiling, while 24 would not. Neck width, DNR, AR, and MOA were obtained from each aneurysm by using prototype software. These parameters were then correlated with the requirement of stent-assisted coiling. RESULTS: MOA and neck width of aneurysms requiring stent-assisted coiling were significantly larger than those not requiring stent-assisted coiling ( P < .001 and <0.001, respectively). Although the DNR and AR of aneurysms requiring stent-assisted coiling were smaller than those not requiring it, the difference was not significant ( P = .22 and 0.12, respectively). ROC analysis revealed that MOA was the parameter that best correlated with the need for stent-assisted coiling. Inclusion of MOA with the rest of the parameters significantly increased the predictive performance regarding the need for stent-assisted coiling ( P = .005). CONCLUSIONS: In this small study, MOA was a useful parameter to predict the need for stent-assisted coiling in ICA sidewall aneurysms. Further prospective study of this parameter for aneurysms at multiple locations is required to determine its ultimate value. Abbreviations: AR, aspect ratio • AUC, area under the curve • CI, confidence interval • DNR, dome-to-neck ratio • DSA, digital subtraction angiography • ICA, internal carotid artery • MOA, maximum ostium angle • OphA, ophthalmic artery • PcomA, posterior communicating artery • ROC, receiver operating characteristic • SHA, superior hypophyseal artery Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2011 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Aug 1, 2011

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