Introduction The use of digital subtraction angiography (DSA) for semi-quantitative cerebral blood flow (CBF) assessment is a new method. In this report we sought to correlate angiographic transit times (TT) in patients with aneurysmal subarachnoid haemorrhage (aSAH) in relation to Hunt &Hess (H&H) grade.
Methods A cohort of 28 patients with aSAH were included. Demographic variables, neurological status, and comorbidities were collected. We developed a method to measure CBF by colour-coding reconstruction from DSA contrast intensity. Regions of interest were chosen over major cerebral vessels (see legend Figure 1). The estimated TT included Time-To-Peak (TTP) from 0–100% intensity (TTP–100,), TTP from 25–100% (TTP25-–00), and TT from 100-–0% (TT100-–). Student t-test was used to compare TT between group 1 (H&H 1–2) and 2 (H&H 3–5).
Results There was no difference in demographic factors between groups 1 (n = 10) and 2 (n = 18). The majority of patients in-group 2 (all except 3) had an external ventricular catheter with normal intracranial-pressure documented during DSA. There was a strong correlation in all TT between M1, M2, A1 and A2. There was a statistically significant difference in M1-TTP–100, between groups 1 and 2 (1.98 vs. 2.43 sec, p = 0.005), M1-TTP25-–00 (1.78 vs. 2.7 sec, p = 0.003) and in M1-TT100-– (4.68 vs. 6.27 sec, p = 0.012) respectively. Similar difference were observed in A1; A1-TTP0-100 (1.84 vs. 2.18 sec, p = 0.001), A1-TTP25-100, (1.63 vs. 2.27 sec, p = 0.001) and in A1-TT100-10(4.24 vs. 5.12 sec, p = 0.0015, and for the M2 region; M2-TTP0-100, (2.03 vs. 2.64 sec, p = 0.001), M2-TTP25-100, (1.83 vs. 2.8 sec, p = 0.001) and in M2-TT100-10 (4.68 vs.6.2 sec, p = 0.012) (Figures 2 and 3).
Conclusion The DSA TT showed significant correlation with H&H grade. TT delays appear to be independent of increased intracranial pressure and may be an indicators of decreased cerebral perfusion in patients with higher H&H grade. The method may serve as an indirect technique for cerebral blood flow assessment in the angiography suite.
Disclosures A. Ivanov: None. C. Hsu: None. A. Linninger: None. S. Amin-Hanjani: None. V. Aletich: 2; C; Covedien, Codman. F. Charbel: None. A. Alaraj: None.
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