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Value of Flat-detector Computed Tomography Angiography with Intravenous Contrast Media Injection in the Evaluation and Treatment of Acutely Ruptured Aneurysms of the AcomA complex: A Single Center Experience in 15 Cases

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Abstract

Objective

To illustrate the added value of flat-detector computed tomography angiography with intravenous contrast media injection (intravenous FDCTA) in the evaluation of complex A1/A2/AcomA aneurysms.

Patients and Methods

We retrospectively reviewed 15 patients with ruptured aneurysms. In each patient, an intravenous FDCTA was performed and its diagnostic value investigated.

Results

In all patients, FDCTA contributed relevant additional information concerning the anatomy of the A1/A2/AcomA complex and the relationship of the aneurysm neck to these vascular structures, which could not be gained by 2D- and 3D-DSA, and changed the management in 33% of the patients (5 out of 15). In an additional 5 cases, knowledge of the detailed anatomy was helpful to plan the exact stent position.

Conclusion

In case of complex A1/A2/AcomA aneurysms, intravenous FDCTA is an effective option to visualize the exact location of the aneurysm neck and the relationship between the aneurysm and the adjacent vessels. Thus, it is of significant added value in the precise planning of a therapeutic strategy.

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Abbreviations

AcomA:

Anterior communicating artery

2D-DSA:

two-dimensional digital subtraction angiography

3D-DSA:

three-dimensional rotational digital subtraction angiography

ICA:

internal carotid artery

FDCTA:

flat-detector computed tomography angiography

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Authors and Affiliations

  1. Department of Neuroradiology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany

    Julie Rösch, Stefan Lang, Philipp Gölitz, Arnd Doerfler & Tobias Struffert

  2. Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany

    Bernd Kallmünzer

  3. Department of Neurosurgery, University of Erlangen-Nuremberg, Erlangen, Germany

    Karl Rössler

Authors
  1. Julie Rösch
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  2. Stefan Lang
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  3. Philipp Gölitz
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  4. Bernd Kallmünzer
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  5. Karl Rössler
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  6. Arnd Doerfler
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  7. Tobias Struffert
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Corresponding author

Correspondence to Julie Rösch.

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Conflict of interest

J. Rösch, S. Lang, P. Gölitz, B. Kallmünzer, K. Rössler, A. Doerfler and T. Struffert declare that they have no competing interests.

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Rösch, J., Lang, S., Gölitz, P. et al. Value of Flat-detector Computed Tomography Angiography with Intravenous Contrast Media Injection in the Evaluation and Treatment of Acutely Ruptured Aneurysms of the AcomA complex: A Single Center Experience in 15 Cases. Clin Neuroradiol 28, 545–551 (2018). https://doi.org/10.1007/s00062-017-0592-x

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  • DOI: https://doi.org/10.1007/s00062-017-0592-x

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