ORIGINAL RESEARCH INTERVENTIONAL Yield of Repeat 3D Angiography in Patients with Aneurysmal-Type Subarachnoid Hemorrhage X R.S. Bechan, X W.J. van Rooij, X J.P. Peluso, and X M. Sluzewski ABSTRACT BACKGROUNDANDPURPOSE: Aneurysmal-typesubarachnoidhemorrhageisaseriousdiseasewithhighmorbidityandmortality.When no aneurysm is found, the patient remains at risk for rebleeding. Negative ﬁndings for SAH on angiography range from 2% to 24%. Most previous studies were based on conventional 2D imaging. 3D rotational angiography depicts more aneurysms than 2D angiography. The purpose of this study was to evaluate the yield of repeat 3D rotational angiography in patients with aneurysmal-type SAH with negative initial 3D rotational angiography ﬁndings and to classify the initial occult aneurysms. MATERIALS AND METHODS: Between March 2013 and January 2016, 292 patients with SAH and an aneurysmal bleeding pattern were admitted.Ofthese292patients,30(10.3%;95%CI,7.3%–14.3%)hadinitialnegative3Drotationalangiographyﬁndingswithin24hours.These patients underwent a second 3D rotational angiography after 7–10 days. RESULTS: In8of30patients(26.7%;95%CI,14.0%–44.7%)withinitialnegative3Drotationalangiographyﬁndings,arupturedaneurysmwas found on repeat 3D rotational angiography. Three of 8 initial occult aneurysms were very small (1–2 mm), 2 were supraclinoid carotid artery dissecting aneurysms (2 and 8 mm), 2 were small (1 and 3 mm) basilar perforator aneurysms, and 1 was a 3-mm vertebral artery dissecting aneurysm. CONCLUSIONS: In10%ofpatientswithaneurysmal-typeSAH,initial3Drotationalangiographyﬁndingswerenegative,andin1in4,repeat 3D rotational angiography demonstrated a ruptured aneurysm. Initial occult aneurysms were dissecting aneurysms
American Journal of Neuroradiology – American Journal of Neuroradiology
Published: Dec 1, 2016
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