E-186 The woven endobridge device for ruptured intracranial aneurysms: a systematic review and meta-analysis

N Alotaibi, P Harker, F Robertson, J Vranic, M Koch, C Stapleton, T Leslie-Mazwi, A Patel
2020 Electronic Poster Abstracts   unpublished
In this case series of SAH patients that were diagnosed with ruptured blister aneurysms, we investigated the role of highresolution (HR)-MRI Vessel Wall Imaging (VWI) in identifying culprit, ruptured aneurysm diagnoses. Methods and Materials We performed an IRB-approved retrospective review of patients diagnosed with SAH from 2010-2019 at our institution. We studied patient demographics, presentations, aneurysm size/locations, initial and follow-up imaging including CT, CTA/MRA, DSA, and MR
more » ... RA, DSA, and MR VWII studies. Results Seven patients (1 Male: 6 Female, mean age: 52) with ruptured blister aneurysms were identified. Median of Hunt-Hess grade (range: 1-4) and Fisher grade (range: 2-4) at presentation were 1 and 3 respectively. Blister aneurysm were small 1-3 mm in mean size and broad based neck morphology in the anterior circulation. All but 2 of them were located in non-branching sites. Initial CTA was diagnostic for a ruptured blister aneurysm in 3/7 (43%), confirmed with DSA. In the remaining 4/7 cases CTA was negative, and DSA identified two of these occult ruptured blister aneurysm initially and two subsequently on 1 week follow-up DSA. HR-MR VWI was performed in 3/4 patients 1-3 days after presentation and revealed mild to moderate focal enhancement and/or T1 hyperintensity of the small aneurysm wall corresponding to the blister aneurysm sites confirmed by initial or follow-up DSA. Conclusion HR-MR VWI can provide adjunctive diagnostic information for the identification of occult ruptured blister aneurysm in SAH patients, when combined with conventional imaging studies such as CTA and DSA. HR-MR VWI may assist in accelerate the time to definite diagnosis in cases with negative initial CTA or DSA findings. Abstract E-186 Figure 1
doi:10.1136/neurintsurg-2020-snis.217 fatcat:wxmoakqrdvhojnixkiv5t4z4py