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Research ArticleNeurointervention

3D Rotational Angiography: The New Gold Standard in the Detection of Additional Intracranial Aneurysms

W.J. van Rooij, M.E. Sprengers, A.N. de Gast, J.P.P. Peluso and M. Sluzewski
American Journal of Neuroradiology May 2008, 29 (5) 976-979; DOI: https://doi.org/10.3174/ajnr.A0964
W.J. van Rooij
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M.E. Sprengers
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A.N. de Gast
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J.P.P. Peluso
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M. Sluzewski
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    Fig 1.

    A 2-mm middle cerebral artery aneurysm missed on DSA in 45-year-old man. A–D, DSA in 4 projections fails to depict an aneurysm. E, Demonstration of an aneurysm on 3DRA (arrow).

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    Fig 2.

    Two angiographically occult additional microaneurysms adjacent to a ruptured posterior inferior cerebellar artery aneurysm in a 53-year-old woman. A and B, DSA in 2 projections demonstrates a posterior inferior cerebellar artery aneurysm. C, 3DRA detects 2 additional microaneurysms (arrows).

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    Fig 3.

    A 44-year-old woman with subarachnoid hemorrhage. A and B, DSA in 2 projections reveals a posterior communicating artery aneurysm and an asymptomatic left parietal arteriovenous malformation. C, 3DRA shows, besides the posterior communicating artery aneurysm, 3 additional small aneurysms on the supraclinoidal carotid and proximal A1 arteries (short arrows) and on a fenestrated anterior communicating artery (long arrow).

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    Fig 4.

    Four examples of small additional aneurysms missed on DSA. A, A very small (0.5 mm) A1 aneurysm (arrow) in a patient with a ruptured middle cerebral artery aneurysm. B, Two supraclinoidal aneurysms (arrows) in a patient with a ruptured posterior communicating artery aneurysm. C, Two middle cerebral artery aneurysms (arrows) in a patient with a ruptured pericallosal artery aneurysm (not shown). D, An intracavernous carotid artery aneurysm (arrow) in a patient with a large ophthalmic artery aneurysm, symptomatic by mass effect.

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    Fig 5.

    Four more examples of missed additional aneurysms on DSA. A, A small middle cerebral artery aneurysm (arrow) in a patient with a ruptured anterior communicating artery aneurysm. B, Two small additional aneurysms on the anterior communicating and middle cerebral arteries (arrows) in a patient with a ruptured anterior communicating artery aneurysm. C, A very small (0.5 mm) A1 aneurysm (arrow) in a patient with a ruptured posterior communicating artery aneurysm. D, A small additional anterior communicating artery aneurysm (arrow) in a patient with a ruptured middle cerebral artery aneurysm.

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American Journal of Neuroradiology: 29 (5)
American Journal of Neuroradiology
Vol. 29, Issue 5
May 2008
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W.J. van Rooij, M.E. Sprengers, A.N. de Gast, J.P.P. Peluso, M. Sluzewski
3D Rotational Angiography: The New Gold Standard in the Detection of Additional Intracranial Aneurysms
American Journal of Neuroradiology May 2008, 29 (5) 976-979; DOI: 10.3174/ajnr.A0964

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3D Rotational Angiography: The New Gold Standard in the Detection of Additional Intracranial Aneurysms
W.J. van Rooij, M.E. Sprengers, A.N. de Gast, J.P.P. Peluso, M. Sluzewski
American Journal of Neuroradiology May 2008, 29 (5) 976-979; DOI: 10.3174/ajnr.A0964
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