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Introduction: Intracranial flow diverting devices are increasingly used to treat cerebral aneurysms. A reliable, non-invasive follow-up modality would be desirable. Our aim was to compare intra-arterial digital subtraction angiography (ia DSA) to angiographic computed tomography with intravenous contrast agent application (iv ACT) in the visualisation of flow diverting devices and aneurysm lumina. Methods: Follow-up monitoring by iv ACT ( n = 36) and ia DSA ( n = 25) in 14 patients treated with flow diverting devices for intracranial aneurysms was evaluated retrospectively. Images were evaluated by two neuroradiologists in anonymous consensus reading regarding the device deployment, wall apposition, neck coverage of the aneurysm, opacification of the vessel and device lumen, as well as the degree of aneurysm occlusion. Results: Corresponding ia DSA and iv ACT images were scored identically in all patients regarding the stent deployment, wall apposition and neck coverage, as well as the degree of aneurysm occlusion and patency status of the device and parent artery. Opacification of the parent vessel lumen and perfused parts of the aneurysm was considered slightly inferior for iv ACT in comparison with ia DSA (seven of 36 cases), without impact on diagnosis. Conclusions: We demonstrated the feasibility and diagnostic value of iv ACT in follow-up imaging of intracranial flow diverting devices. Due to its high spatial resolution and non-invasive character, this novel technique might become a valuable imaging modality in these patients. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the risks of endovascular therapy, aneurysm regrowth, recanalization and the need for reembolization. A prospective analysis was performed on 211 aneurysms treated endovascularly from February 2000 to December 2003. Of these 211 aneurysms, 81 were asymptomatic and 130 were ruptured. The risks of endovascular therapy, aneurysm regrowth, recanalization and the need for reembolization were evaluated. The mean observation time was 10 months (ranging from 178 to 830 days). Complete occlusion (100%) in the initial intervention was achieved in 171 of 201 aneurysms (85%), 80–95% occlusion in 24 aneurysms (12%), and <80% occlusion in 6 aneurysms (3%). Recanalization had occurred at the first follow-up in 34 of all 153 aneurysms reassessed (22.2%). Of 133 aneurysms with initial 100% occlusion, 107 (80.4%) remained completely occluded, 17 (12.7%) showed recanalization, and 9 (6.7%) showed neck regrowth. Among those with 80–95% occlusion, 20 were reassessed, and of these 2 showed spontaneous occlusion, 10 (50%) still showed the initial neck, and 8 (40%) showed increased recanalization. One aneurysm which initially showed <80% occlusion remained unchanged, and another showed showed recanalization. Of the 153 aneurysms, 12 (7.8%) were recoiled, 2 initially <80% occluded, 7 initially 80–95% occluded and 3 initially totally occluded. In spite of low morbidity and mortality, one in four aneurysms will show recurrence. The initial degree of occlusion seems to have an influence on the likelihood of recanalization. [ABSTRACT FROM AUTHOR]