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New devices and technologies
Accuracy of optical coherence tomography imaging in assessing aneurysmal remnants after flow diversion
  1. Frederik Fries1,
  2. Alexander Maßmann2,
  3. Toshiki Tomori1,
  4. Umut Yilmaz1,
  5. Michael Kettner1,
  6. Andreas Simgen1,
  7. Giorgio Cattaneo3,
  8. Gudrun Wagenpfeil4,
  9. Wolfgang Reith1,
  10. Ruben Mühl-Benninghaus1
  1. 1Department of Neuroradiology, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Saarland, Germany
  2. 2Department of Radiology, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Saarland, Germany
  3. 3Institute for Biomedical Engineering, Universität Stuttgart, Stuttgart, Baden-Württemberg, Germany
  4. 4Medical Biometry, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Saarland, Germany
  1. Correspondence to Dr Ruben Mühl-Benninghaus, Department of Neuroradiology, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg 66421, Germany; ruben.mbe{at}gmail.com

Abstract

Background Optical coherence tomography (OCT) is an ultra-high resolution real-time intravascular imaging method that is gaining interest in cerebrovascular applications.

Objective To compare, in a rabbit elastase aneurysm model, digital subtraction angiography (DSA) and OCT as diagnostic tools for the assessment of aneurysmal remnants and baseline characteristics of aneurysms after flow diverter (FD) implantation.

Methods With Institutional Animal Care and Use Committee approval, saccular aneurysms were created in 28 rabbits and treated with Derivo FDs. DSA was performed before, and immediately after, stent implantation. As a follow-up, DSA and OCT were performed 28 days after device implantation.

Results DSA and OCT were successfully performed in 23 cases. OCT could not be achieved in 5 cases owing to navigational difficulties in the stent lumen with the OCT catheter. Residual aneurysms were significantly more often visible with OCT (18/23 (78%) than with DSA 12/23 (52%), p = 0.031).

Conclusion OCT was more sensitive than conventional angiography for the assessment of residual aneurysms at 28 days after FD implantation in an animal model.

  • flow diverter
  • aneurysm
  • neck
  • angiography
  • stent

https://doi.org/10.1136/neurintsurg-2020-016129

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    Footnotes

    • Contributors Study design: RM-B, FF, and WR. Data acquisition: FF, RM-B, AM, TT, UY, AS, and MK. Literature research: FF and RM-B. Data analysis and interpretation: FF, RM-B, TT, GW, and UY. Manuscript preparation: FF, RM-B, and AM. Revision of manuscript for important intellectual content: UY, WR, and GC. Approval of the final version of the manuscript: all authors.

    • Funding This study was funded by the German Ministry of Economic Affairs and Energy (grant No KF2335804AJ2).

    • Competing interests GC was an engineer at the company Acandis (Pforzheim, Germany) until August 2019 and served as a proctor during this study.

    • Patient consent for publication Not required.

    • Ethics approval Approval from the institutional animal care committee was obtained from the Ethikkommission der Ärztekammer des Saarlandes, No 07/17.

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

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.