Three-dimensional reconstructed rotational digital subtraction angiographyin planning treatment of intracranial aneurysms

We evaluated three-dimensional (3D) reconstructions of 200 degrees rotation al digital subtraction angiography (DSA) images for their contributions to improving the safety of endovascular embolization of intracranial aneurysms . Standard DSA and 200 degrees rotational DSA were performed in 40 adult pa tients (aged 21-77 years) with 45 intracranial aneurysms. Information obtai nable from standard DSA and 3D-DSA images about aneurysm shape and size was compared. In 40 (89%) of the 45 aneurysms 3D-DSA gave additional informati on about the anatomy of the aneurysm. In 17 (43%) of these cases aneurysm a natomy could be visualized better on 3D-DSA than on standard DSA images. In three cases only 3D-DSA images showed blood vessels originating from the a neurysm. Reconstructed 3D images were also helpful in visualizing partially clipped aneurysms. On maximum-intensity projection images it was even poss ible to depict previously embolized aneurysms. Blood vessels originating fr om the aneurysm are visible on 3D-DSA images, and even previously clipped a neurysms can be visualized well. Rotational DSA with 3D reconstruction is a helpful tool in the assessment of intracranial aneurysms.