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Neuroimaging
Original research
SuperDyna: Unlocking the Potential of Post-Treatment Device Evaluation
  1. Eytan Raz1,
  2. Vera Sharashidze1,
  3. Erez Nossek2,
  4. Daniel H Sahlein3,4,
  5. Sara Rostanski5,
  6. Charlotte Y Chung1,
  7. Ayaz Mahmood Khawaja1,
  8. Peter Kim Nelson1,2,
  9. Maksim Shapiro1,5
  1. 1 Radiology, NYU Langone Health, New York, New York, USA
  2. 2 Neurosurgery, NYU Langone Health, New York, New York, USA
  3. 3 Interventional Neuroradiology, Goodman Campbell Brain and Spine, Carmel, Indiana, USA
  4. 4 Interventional Neuroradiology, Ascension St Vincent's, Indianapolis, Indiana, USA
  5. 5 Neurology, NYU Langone Health, New York, New York, USA
  1. Correspondence to Dr Eytan Raz, Radiology, NYU Langone Health, New York, NY 10012, USA; eytan.raz{at}gmail.com

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.

  • aneurysm
  • device
  • flow diverter
  • stent
  • technology

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/jnis-2023-020357

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • X @eytanraz, @SharashidzeVera, @ENossek, @ChungCharlotte, @neuroangio1

    • Contributors All authors provided substantial contributions to the conception or design of the work, acquisition, analysis, and interpretation of data for the work. ER, VS, and MS drafted the work. All authors revised the work critically for important intellectual content. All authors approved the final version to be published. ER and MS agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • 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.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.