CT angiography for one-year follow-up of intracranial aneurysms treated with the WEB device: Utility in evaluating aneurysm occlusion and WEB compression at one year

Publication date: Available online 7 March 2018
Source:Journal of Neuroradiology
Author(s): Hélène Raoult, François Eugène, Anthony Le Bras, Géraldine Mineur, Béatrice Carsin-Nicol, Jean-Christophe Ferré, Jean-Yves Gauvrit
Background and purposeThe WEB is an innovative flow disruption device for cerebral aneurysm embolization with rapidly expanding indications. Our purpose was to evaluate the diagnostic performance of CTA at 1-year follow-up of aneurysms treated with the WEB.Materials and methodsBetween April 2014 and May 2016, the study prospectively included patients treated with the WEB at our institution, and followed up within 24hours by CTA and at 1 year by CTA, TOF MRA and DSA. The diagnostic quality of imaging data was assessed based on the confidence index, artifacts, and WEB shape depiction. The imaging diagnostic performance was assessed using 3 criteria at 1 year: aneurysm occlusion status and worsening, and WEB shape compression. Interobserver and intermodality agreement was determined by calculating κ values.ResultsThe study ultimately included 16 patients (9 women, mean age 53 ± 7.6 years). CTA quality confidence was scored as 2/2, artifacts 0.4/2 and WEB shape depiction 1.9/2, superior to TOF MRA for the latter two criteria. Aneurysm occlusion was adequate in 93.7% of patients, with CTA showing excellent interobserver reproducibility and agreement with DSA on a 4-grade scale (κ = 1.00), while TOF MRA yielded good reproducibility (κ = 0.76) and agreement with DSA (κ = 0.69). CTA also identify aneurysm occlusion worsening (43.7%) and WEB compression (81.2%) in excellent agreement with DSA (κ = 0.85 and 1.00).ConclusionsCTA is a reproducible and reliable technique for the follow-up of aneurysms treated with the WEB device.



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