Follow-up of intracranial aneurysms treated by a WEB flow disrupter: a comparative study of DSA and contrast-enhanced MR angiography

J Neurointerv Surg. 2016 Jun;8(6):615-20. doi: 10.1136/neurintsurg-2015-011644. Epub 2015 May 21.

Abstract

Objective: To compare contrast-enhanced MR angiography (CE-MRA) and DSA for the follow-up of intracranial aneurysms (IAs) treated with the Woven EndoBridge embolization system DL (WEB DL; Sequent Medical, Aliso Viejo, California, USA).

Materials and methods: We retrospectively identified all patients treated with a WEB DL between November 2010 and February 2013 in 2 hospitals. The IA occlusion was graded on follow-up CE-MRA and DSA by 4 independent readers and by 2 readers reaching a consensus, respectively. Interobserver agreement for MRA and intertechnique agreement was evaluated by calculating linear weighted κ.

Results: Fifteen patients with 16 IAs were included. Mean delay between MRA and DSA was 2 months (range 0-16 months). Interobserver agreement for MRA was substantial to almost perfect (κ=0.686-0.921; mean κ=0.809). Intertechnique agreement was moderate to substantial (κ=0.579-0.724; mean κ=0.669). Only three out of five inadequately occluded IAs were detected by MRA.

Conclusions: CE-MRA is a useful tool for the follow-up of IAs treated with a WEB DL. However, early follow-up with DSA remains mandatory to detect inadequately occluded IAs.

Keywords: Aneurysm; Device; Magnetic Resonance Angiography.

MeSH terms

  • Adult
  • Aged
  • Angiography, Digital Subtraction*
  • Contrast Media
  • Embolization, Therapeutic*
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / therapy*
  • Magnetic Resonance Angiography*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Contrast Media