title: Technique to detect coil migration using mask images of rotational angiography during stent-assisted coil embolization for ultra-wide necked aneurysms: technical note.
abstract: A novel technique was developed to detect coil migration to the stent interior using mask images of rotational angiography. Stent-assisted coil embolization under x-ray fluoroscopy control was simulated with a hand-made vessel model. The stent interior was observed with a rigid endoscope during coil embolization. After insertion of the coil, mask images using rotational angiography were acquired and multi-planar reformation (MPR) images were reconstructed on a workstation. The stent interior could be observed during coil embolization. Longitudinal MPR images showed the positional relationships between the stent, coil, and tip of the microcatheter. This technique was successfully employed in a patient to detect displacement of the tip of the microcatheter inside the stent. This technique is useful for monitoring stent-assisted coil embolization of an ultra-wide necked aneurysm, but requires extra time and increased radiation exposure, so we recommend use only if coil migration is strongly suspected.
authors: Center for Endovascular Neurosurgery, Osaka Neurological Institute, Toyonaka, Osaka, Japan.
authors: Tomoyoshi
authors: T
authors: Shigematsu
authors: Shingo
authors: S
authors: Toyota
authors: Yasunori
authors: Y
authors: Fujimoto
authors: Hiroshi
authors: H
authors: Yamamoto
authors: Akatsuki
authors: A
authors: Wakayama
authors: Toshiki
authors: T
authors: Yoshimine
mesh_terms: D000368:Aged; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D002404:Catheterization / Q000295:instrumentation / Q000379:methods / Q000592:standards; D002533:Cerebral Angiography / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007091:Image Processing, Computer-Assisted; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D007431:Intraoperative Complications / Q000000981:diagnostic imaging* / Q000517:prevention & control; D008953:Models, Anatomic; D016343:Monitoring, Intraoperative / Q000379:methods; D019736:Prostheses and Implants / Q000009:adverse effects* / Q000592:standards; D011829:Radiation Dosage; D015607:Stents / Q000592:standards