The utility of DynaCT in neuroendovascular procedures

Abstract

The authors present 3 patients who underwent neuroendovascular procedures in which DynaCT produced by a flat-panel detector facilitated management of complications. As part of a combined CT/angiography suite, DynaCT offered the major advantage of immediate detection or exclusion of intracranial complication without patient transfer. The quality of cone-volume CT-generated images produced by DynaCT was sufficient to make a diagnosis.

Figures

Fig 1.

A, DynaCT acquisition demonstrating rotation of FD C-arm (curved arrow) during actual case. B, A screen shot of acquired orthogonal images immediately available to the user after acquisition and postprocessing.

Fig 2.

DynaCT was performed following vessel perforation (A ) and demonstrated increased ventriculomegaly compared with preoperative CT scan (B).

Fig 3.

This patient experienced cardiac arrest and aneurysm rehemorrhage was suspected. After emergent ventriculostomy placement, however, DynaCT (A) demonstrated no new intracranial hemorrhage, which indicates a primary cardiac event. Note good catheter placement and interhemispheric air (arrow). Preoperative CT scan (B) is shown for comparison.

Fig 4.

DynaCT (A) demonstrated unexpected subdural hematoma and occipitoparietal intraparenchymal hemorrhage. A conventional CT scan (B) was later obtained before patient transfer to the operating room, which revealed increased hemorrhage and mass effect.