Usefulness of the three-dimensional computed tomography angiography in the control of clipped cerebral aneurysms presenting with subarachnoid hemorrhage [Valor de la angiotomografía tridimensional en el control post-clipaje de los aneurismas cerebrales que se presentan con hemorragia subaracnoidea]

Abstract

Introduction: Three-dimensional CT angiography (3DCTA) in diagnosis of cerebral aneurysms has replaced the invasive, but traditional catheter-based method of intra-arterial digital subtraction angiography (IADSA). This method has also been reported useful in the control of clipped aneurysms. Objective: To evaluate the utility of 3D-CTA in the control of clipped cerebral aneurysms after a subarachnoid hemorrhage (SAH) in a referral hospital. Patients and methods: We studied consecutive patients with SAH and clipped aneurisms, in a 24-month period, who had pre- and post-clipping 3D-CTA, as well as information on the clinical condition at hospital arrival, aneurysms localization and other features. The failure or success of aneurismal clipping was determined by 3D-CTA review by a radiologist blinded to the surgical procedure, and the intervention description by the neurosurgical team. Results: Twenty-eight patients were eligible for the present analysis; 16 (57%) women, mean age 50.5 years (range: 22-78 years). There were 32 aneurysms among the 28 patients (86% cases of solitaire and 14% with multiple aneurysms). In all, 97% were localized at the anterior circulation and 3% in the vertebro-basilar system. In only one (3%) patient failure of clipping was detected, which perfectly correlated with the neurosurgical team description. Conclusions: 3D-CTA is useful in the control of clipped cerebral aneurysms, with the advantage that it is a non-invasive method. © Copyright Indice Mexicano de Revistas Biomédicas Latinoamericanas 1998 - 2011.