Abstract
Purpose: This pilot study demonstrates an approach to quantitatively evaluate the effectiveness of flow diverter (FD) stents and coil treatments based on follow-up images. Method: 2D digital subtraction angiography (DSA) images from 18 aneurysm patients were analyzed using IS FlowMap flow analysis software. Each patient had DSA images (3 frames/sec) acquired before, after the FD treatment and during follow-up examinations. 11 patients received FD treatment, and 7 patients received FD and coil combined treatment. The percentage of blood flow redirected into the parent artery was calculated. The relative aneurysm blood flow reduction caused by the stent was obtained. Based on the inlet contrast (CA) concentration profile, the blood flow changes in aneurysm and vessel blood flow were obtained. Result: 18 patients’ average aneurysm blood flow reduction was 52% after the treatment. All scaled aneurysm CA concentration profile slopes before and after the treatment showed a clear difference (p=0.003). Post-treatment aneurysm CA slopes decreased 36% in average compared to pre-treatment, indicating a lower inflow rate of blood entering the aneurysm after the treatment. 7 patients with FD and coil combined treatment showed an average of 54% aneurysm blood flow reduction right after the treatment. FD and coil combined treatment had an average of 73% aneurysm blood flow reduction in patients’ first DSA follow up (8±3 months post treatment). Representative cases of FD and Coil combined treatment (flow reduction 53% right after the treatment; 89% at the 8 month follow-up) and FD only (flow reduction 48% right after the treatment; 75% at the 6 month follow-up) are shown in the figure. Conclusion: IS FlowMap quantitatively measures the effectiveness of treatment in patients with brain aneurysms using only 2D DSA. The result suggests that FD and coil combined treatment is more effective in preventing aneurysm blood inflow during the healing process.
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