scholarly journals Detection of the Origin of the Cystic Artery during Transcatheter Arterial Embolization of Hepatocellular Carcinomas: Comparison of Cone Beam CT and Digital Subtraction Angiography

2009 ◽  
Vol 21 (2) ◽  
pp. 85-93
Author(s):  
Takashi HASHIZUME ◽  
Minoru HONDA ◽  
Toshi HASHIMOTO ◽  
Noritaka SEINO ◽  
Takehiko GOKAN
Keyword(s):  
Digital Subtraction Angiography ◽  
Transcatheter Arterial Embolization ◽  
Cone Beam Ct ◽  
Arterial Embolization ◽  
Cystic Artery ◽  
Cone Beam ◽  
Digital Subtraction ◽  
Hepatocellular Carcinomas

Benefit of cone-beam computed tomography angiography in acute management of angiographically undetectable ruptured arteriovenous malformations

2013 ◽  
Vol 119 (4) ◽  
pp. 1015-1020 ◽  
Author(s):  
Jason P. Rahal ◽  
Adel M. Malek
Keyword(s):  
Digital Subtraction Angiography ◽  
Ct Angiography ◽  
Arteriovenous Malformations ◽  
Cone Beam Ct ◽  
Gamma Knife Radiosurgery ◽  
Imaging Modalities ◽  
Cone Beam ◽  
Digital Subtraction ◽  
Conventional Angiography ◽  
The Third

Object Ruptured arteriovenous malformations (AVMs) are a frequent cause of intracerebral hemorrhage (ICH). In some cases, compression from the associated hematoma in the acute setting can partially or completely occlude an AVM, making it invisible on conventional angiography techniques. The authors report on the successful use of cone-beam CT angiography (CBCT-A) to precisely identify the underlying angioarchitecture of ruptured AVMs that are not visible on conventional angiography. Methods Three patients presented with ICH for which they underwent examination with CBCT-A in addition to digital subtraction angiography and other imaging modalities, including MR angiography and CT angiography. All patients underwent surgical evacuation due to mass effect from the hematoma. Clinical history, imaging studies, and surgical records were reviewed. Hematoma volumes were calculated. Results In all 3 cases, CBCT-A demonstrated detailed anatomy of an AVM where no lesion or just a suggestion of a draining vein had been seen with other imaging modalities. Magnetic resonance imaging demonstrated enhancement in 1 patient; CT angiography demonstrated a draining vein in 1 patient; 2D digital subtraction angiography and 3D rotational angiography demonstrated a suggestion of a draining vein in 2 cases and no finding in the third. In the 2 patients in whom CBCT-A was performed prior to surgery, the demonstrated AVM was successfully resected without evidence of a residual lesion. In the third patient, CBCT-A allowed precise targeting of the AVM nidus using Gamma Knife radiosurgery. Conclusions Cone-beam CT angiography should be considered in the evaluation and subsequent treatment of ICH due to ruptured AVMs. In cases in which the associated hematoma compresses the AVM nidus, CBCT-A can have higher sensitivity and anatomical accuracy than traditional angiographic modalities, including digital subtraction angiography.

Type 2 endoleaks in endovascular aortic repair: cone beam CT and automatic vessel detection to guide the embolization

2017 ◽  
Vol 59 (6) ◽  
pp. 681-687 ◽  
Author(s):  
Anna Maria Ierardi ◽  
Filippo Pesapane ◽  
Nicola Rivolta ◽  
Enrico Maria Fumarola ◽  
Salvatore Alessio Angileri ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Clinical Success ◽  
Cone Beam Ct ◽  
Arterial Embolization ◽  
Cone Beam ◽  
Fluoroscopy Time ◽  
Iodinated Contrast Medium ◽  
Iodinated Contrast ◽  
Vessel Detection ◽  
The Mean

Background Dual-phase cone beam computed tomography (DP-CBCT) and automatic vessel detection (AVD) software are helpful tools for detecting arteries before planned endovascular interventions. Purpose To evaluate the usefulness of DP-CBCT and AVD software in guiding the trans-arterial embolization (TAE) of challenging T2 lumbar endoleaks (T2-L-EL). Material and Methods Ten patients with T2-L-EL were included in this study. The accuracy of DP-CBCT and the AVD software was defined by the ability to detect the endoleak and arterial feeding vessel, respectively. Technical success was defined as the correct positioning of the microcatheter using AVD software and the successful embolization of the endoleak. Clinical success was defined as the absence of recurrent endoleaks during follow-up and the stability of the sac diameter for persistent endoleaks. The total volume of iodinated contrast medium, overall procedure time, mean procedural radiation dose, and mean fluoroscopy time were recorded. Results The EL was detected by DP-CBCT in all patients. The AVD software identified the feeding arterial branch in all cases. In one patient, the nidus of the endoleak was not reached due to the small caliber of the feeding artery, even though the software had clearly identified the vessel route. The mean contrast volume was 109 mL, the mean overall procedural time was 74.3 min. The mean procedural radiation dose was 140.97 Gy cm2, and the mean fluoroscopy time was 29.8 min. Conclusion The use of DP-CBCT and the AVD software is feasible and may facilitate successful embolization in challenging occult T2-L-EL with complex vasculature.

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