PubMed · 14127479
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K H VAN DE WEYER, H BUHL. 1964. [MULTIPLE CEREBRAL ANEURYSMS].. https://pubmed.ncbi.nlm.nih.gov/14127479/
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Arterial dissection, pseudoaneurysm, arteriovenous fistula, arterial laceration and occlusion are uncommon complications of blunt trauma. Angiography has been considered the primary method of evaluation to assess for vascular injuries but, due to the low frequency of these lesions, its screening role has been challenged. Non-invasive imaging, particularly CT angiography (CTA), offers definitive advantages and has emerged as a promising diagnostic screening method. Angiography is shifting to a rather therapeutic role and the endovascular management of these lesions is briefly discussed.
Three-dimensional (3D) vascular models are important in medical education, interventional radiology and vascular surgery. Because of a limited quality of angiographic images and inaccuracies introduced during their processing, interactive enhancement of the resulting models is required. We introduce here a novel tool, the interactive vascular modeling environment (IVME) for editing, manipulation, quantification, and labeling of cerebrovascular models. We describe the IVME architecture and design along with the functionality supporting anatomy terminology linking, 2D and 3D labeling, editing, 2D-3D cross-referencing, measurements, and quantification. The IVME is a useful platform in education, research, and clinics to explore and manipulate the angiography data in 2D and 3D.
BACKGROUND AND PURPOSE: The durability of aneurysm coil embolization is thought to depend on packing density. The expansile property of hydrogel coating on coils increases volumetric packing per coil length. We describe our experience using hydrogel-coated coils (HydroCoils) compared with inert platinum coils in intracranial aneurysm embolization. METHODS: Fifty aneurysms embolized primarily using HydroCoils from 2003 to 2004 were compared with 57 volume- and shape-matched aneurysms treated with standard platinum coils from 2000 to 2003. Outcome measures included volumetric percentage occlusion (VPO), length and number of coils used, procedure time, fluoroscopy time, contrast volume, coil cost, length of hospital stay, and durability of therapy. RESULTS: Seventeen/26/5 small/medium/large aneurysms treated with HydroCoils were matched with 29/24/4 small/medium/large aneurysms treated with inert platinum. HydroCoil embolization yielded significantly greater VPO (84.8% versus 29.8%; P<0.001), decreased average total coil length used per aneurysm (33.2 versus 44.3 cm), reduced fluoroscopy time (53.2 versus 65.2 minutes; P=0.016), but increased contrast volume used (174.8 versus 112.9 cc; P<0.001). There were no differences in length of hospital stay. Procedure-related morbidity and mortality rates in the HydroCoil cohort were 4% and 0%, respectively. Follow-up angiography at mean 12.3 months revealed lower aneurysm recurrence rates (17% versus 24%; number-needed-to-treat [NNT] 14.3). Initial costs associated with HydroCoil embolization were higher ($5835 versus $4017; P=0.004) but countered by lower retreatment rates (10% versus 17%; NNT 14.3). CONCLUSIONS: HydroCoil embolization achieves greater aneurysm packing density with decreased coil length. Initial durability data favor HydroCoils, with lower recurrence and retreatment rates.