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SuperDyna: Unlocking the Potential of Post-Treatment Device Evaluation.

Authors :: Raz E
Sharashidze V
Nossek E
Sahlein DH
Rostanski S
Chung CY
Khawaja AM
Nelson PK
Shapiro M
Source :: Journal of neurointerventional surgery [J Neurointerv Surg] 2024 Apr 23; Vol. 16 (5), pp. 512-515. Date of Electronic Publication: 2024 Apr 23.
Publication Year :: 2024
Abstract: Background: Current imaging algorithms for post-device evaluation are limited by either poor representation of the device or poor delineation of the treated vessel. Combining the high-resolution images from a traditional three-dimensional digital subtraction angiography (3D-DSA) protocol with the longer cone-beam computed tomography (CBCT) protocol may provide simultaneous visualization of both the device and the vessel content in a single volume, improving the accuracy and detail of the assessment. We aim here to review our use of this technique which we termed "SuperDyna". Methods: In this retrospective study, patients who underwent an endovascular procedure between February 2022 and January 2023 were identified. We analyzed patients who had both non-contrast CBCT and 3D-DSA post-treatment and collected information on pre-/post-blood urea nitrogen, creatinine, radiation dose, and the intervention type. Results: In 1 year, SuperDyna was performed in 52 (of 1935, 2.6%) patients, of which 72% were women, median age 60 years. The most common reason for the addition of the SuperDyna was for post-flow diversion assessment (n=39). Renal function tests showed no changes. The average total procedure radiation dose was 2.8 Gy, with 4% dose and ~20 mL of contrast attributed to the additional 3D-DSA needed to generate the SuperDyna. Conclusions: The SuperDyna is a fusion imaging method that combines high-resolution CBCT and contrasted 3D-DSA to evaluate intracranial vasculature post-treatment. It allows for more comprehensive evaluation of the device position and apposition, aiding in treatment planning and patient education. Competing Interests: Competing interests: ER is stock owner of Siemens, proctor of Microvention, and consultant for Medtronic and Balt. MS is consultant for Medtronic and Balt. DHS is consultant for Siemens, Microvention, Balt and Medtronic. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)