You are here

Article Text

Article menu
Neuroimaging
Original research
Multimodal angiographic assessment of cerebral arteriovenous malformations: a pilot study
  1. Raphaël Blanc1,
  2. Aude Seiler1,
  3. Thomas Robert1,
  4. Humain Baharvahdat2,
  5. Maxime Lafarge1,3,
  6. Julien Savatovsky4,
  7. Jérôme Hodel5,
  8. Gabriele Ciccio1,
  9. Dorian Chauvet6,
  10. Silvia Pistocchi1,
  11. Bruno Bartolini1,
  12. Hocine Redjem1,
  13. Michel Piotin1
  1. 1Department of Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France
  2. 2Neurosurgical Department, Ghaem Hospital-Mashhad University of Medical Sciences, Teheran, Iran
  3. 3Institut supérieur des biosciences, Université Paris-Est- Créteil, Paris, France
  4. 4Department of Neuroradiology, Saint Joseph Hospital, Paris, France
  5. 5Department of Neuroradiology, Fondation Rothschild Hospital, Paris, France
  6. 6Department of Neurosurgery, Hopital de la Pitié-Salpetrière, Paris, France
  1. Correspondence to Dr R Blanc, Department of Interventional Neuroradiology, Fondation Rothschild Hospital, 25 rue Manin, Paris 75019, France; rblanc{at}fo-rothschild.fr

Abstract

Purpose We describe our protocol of three-dimensional (3D) Roadmap intracranial navigation and image fusion for analysis of the angioarchitecture and endovascular treatment of brain arteriovenous malformations (AVMs).

Methods We performed superselective catheterization of brain AVMs feeders under 3D-Roadmap navigation. Angiograms of each catheterized artery on two registered orthogonal views were transferred to the imaging workstations, and dedicated postprocessing imaging software allowed automated multiple overlays of the arterial supply of the AVM superselective acquisitions on the global angiogram in angiographic or 3D views and on coregistered MRI datasets.

Results 11 untreated brain AVMs (4 with hemorrhagic presentation) were explored. The superselective acquisitions were performed under 3D-Roadmap navigation in 74 arteries, for a total of 79 targeted arteries. Imaging analysis was available at table side or postoperatively for discussion of the therapeutic strategy. No complications occurred during superselective catheterization. The accuracy of the coregistration of angiogram and MRI was submillimetric after automated mutual information coregistration, with manual re-registration by the physicians.

Conclusions Superselective angiograms acquired under 3D-Roadmap navigation can be postprocessed with multiple overlays. The fluoroscopic navigation under 3D-Roadmapping and the coregistration of 3D rotational angiography, selective angiography, and 3D MR datasets appears reliable with millimeter accuracy, and could be implemented in the critical brain AVM embolization setting to allow refined analysis of AVM angioarchitecture.

  • Arteriovenous Malformation
  • Angiography
  • Vascular Malformation

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/neurintsurg-2014-011402

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Supplementary materials

    • Supplementary Data

      This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

      Files in this Data Supplement: