Abstract:

Background and purpose: flow-diverting devices are increasingly used for the treatment of giant and wide neck cerebral aneurysms. The aim of the research was to evaluate the feasibility of computed tomography angiography CTA in the postoperative evaluation of aneurysms treatec with Pipeline Embolization Device (PED).

Materials and methods: fifteen patients with 19 aneurysms treated by total of 17 PED were examined by means of CTA. Postprocessing of CTA acquisitions were done at workstation using maximum intensity projections, multiplanar reformations, curved planar reformations and volume rendering of PED region and other intracranial arteries. The position of PED and dergree of aneurysm occlusion were evalluated.

Results: CTA follow-up of at least 26 months demonstrated complete occlusion of aneurysms treated with the PED in 9 cases (50%). There were 2 cases (11,1%) of proximal stent migration and 2 cases (11,1%) of stent narrowing due to incomlete expansion. Flow reduction was observed in 4 aneurysms (22,2%). CTA was accurate in determining the position of PED and evaluating the patency of aneurysm.

Conclusions: CTA can be used as a reliable tool for postoperative evaluation of aneurysms treated with PED defining the stent position and aneurysmal flow reduction. Postprocessing using curved planar reformations with window width 1000-2500 and level 600-800 is optimal for stent visualization.  

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