Abstract

Article provides a literature review on problems of diagnosing of intracranial aneurysms (IA) rupture and its complications.

Aim: was to study relevant data on the use of computed tomography (CT), as well as other imaging methods, in patients with ruptured aneurysms in the acute period.

Materials and methods: a search was conducted for publications on this topic, dating up to December 2019, using main Internet resources: PubMed databases, scientific electronic library (Elibrary), Scopus, ScienceDirect, Google Scholar.

Results: we analyzed 45 literature sources, covering the period from 1993 to 2019, which include 3 meta-analyzes, 5 descriptions of studies evaluating the effectiveness of various visualization methods for ruptured IA. Both foreign and Russian publications were involved.

Conclusion: native CT is the leading visualization method to detect hemorrhages in nearest hours after the rupture of IA. CT angiography in combination with digital subtraction angiography (DSA), according to the vast majority of authors, allows to make thorough preoperative planning in the shortest time, as well as to identify unruptured aneurysms. Based on the obtained data, it is advisable to conduct a study to assess the role of CT in the acute period of IA rupture, as well as in the diagnosis of complications in the early postoperative period.

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Abstract:

Aim: was to evaluate possibilities and advantages of endovascular treatment of intracranial aneurysms (IA) and arteriovenous malformations (AVM) using three-dimensional navigation (3D-roadmapping).

Materials and methods: during 2010-2013 years 103 embolizations of IA and AVM ir 88 patients were performed in our angiography department. Embolizations of IA were managed by metallic detachable coils, embolizations of AVM - by Histoacryl : Lipiodol glue composition. 3D-roadmapping technique was applied for guidance of endovascular tools in cerebral arteries anc catheterization the IA cavity and AVM-feeding arteries during the procedure. 3D-roadmapping technique is based on creation of composite images that consist of two-dimensional fluoroscopic views superimposed on virtual three-dimensional model of the vessel.

Results: endovascular interventions with 3D-roadmapping were performed in 65(63%) cases. In 49 (75%) cases we used 3DRA data to create three-dimensional model of cerebral vessels and in 16 (25%) cases - CT-angiography data. Complex algorithm of diagnosis and endovascular treatment of IA and AVM using 3D-roadmapping was introduced.

Conclusion: our experience of the endovascular embolization of IA and AVM with 3D-roadmapping convincingly showed that usage of this technique is possible and effective. In comparison with two-dimensional navigation there was a tendency in reduction of the effective exposure dose, also there was a statistically significant decrease of amount of contrast material , and of time for superselective catheterization of AVM-feeding arteries and IA cavity. 

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