EP32 First 100 cases of trans-radial access in neuro-intervention – a single centre experience

K Wells, N Qayyum, CK Jadun, Z Hashim
2021 ESMINT 2021 – Abstract book   unpublished
Introduction Delayed stenosis can occur following flow diverter (FD) treatment of cerebral aneurysms. Vessel wall MRI (vwMRI) using black blood (BB) sequences can improve evaluation of intracranial vascular pathologies. Aim vwMRI studies after FD treatment of unruptured intracranial aneurysms were assessed for findings associated with stenosis on digital subtraction angiography (DSA). Methods According to an IRB-approved protocol, patients with unruptured aneurysms treated with FD were
more » ... d in a prospectively-maintained database. FDs with stenosis on sixmonth DSA were identified, and control cases were then selected, matching for age, gender, vessel segment, and morphology. Three-month vwMRI studies were then evaluated. Stenosis was measured on 3D time of flight (3DTOF) and post-contrast MRA, as well as post-contrast black blood (BB) images. Downstream flow limitation (DFL), intra-FD tissue on BB, or intra-FD intimal enhancement were noted. Fisher's exact tests were performed to compare study groups and identify vwMRI features associated with stenosis on subsequent DSA. Multivariable exact logistic regression analysis was performed using variables with p£0.200. Results 15 patients were analyzed, with no difference in matched variables between patients with and without confirmed stenosis (p=0.267-0.706). Stenosis on BB (p=0.035), DFL on 3DTOF (p=0.004) and postcontrast (p=0.001) MRA, and intimal enhancement (p=0.001) were associated with stenosis on subsequent DSA. Stenosis on 3DTOF (p=0.264) or postcontrast (p=0.210) MRA and intra-FD tissue on BB (p=0.231) were not. Multivariable analysis found retained significance for stenosis and intimal enhancement on BB (p=0.001). Conclusions Stenosis and intimal enhancement within the FD on BB are associated with stenosis on subsequent DSA. REFERENCES 1. Mossa-Basha M, Alexander M, Gaddikeri S, Yuan C, Gandhi D. Vessel wall imaging for intracranial vascular disease evaluation.
doi:10.1136/neurintsurg-2021-esmint.32 fatcat:antycme6k5agzhh24faewtxyai