Cinematic Angiography for Measurements of Blood Flow in Cerebral Aneurysms With Stents

Background and Purpose: The assessment of blood flow speed by imaging modalities is important for endovascular treatments, such as stent implantation, of cerebral aneurysms. The subtracted vortex centers path line method (SVC method) is one of the ways of determining flow speed quantitatively using the image sequence. And a cinematic angiography (CA) is a high speed image acquisition system using X-ray and contrast media integrated in Digital Subtraction Angiography (DSA) for endovascular therapy. The combination of SVC and CA may useful for determining the blood flow speed during the operation using DSA. In this study, we applied this combination to analyze hemodynamic changes before and after stenting. Methods: A transparent tubular model was constructed of silicone which included an aneurysm 10 mm in diameter and having a 5 mm neck on a straight parent artery with a diameter of 3.5 mm. The model was integrated into a pulsatile circulation system. A double layer stent was placed in the parent artery on the aneurysm. By CA, successive images at 25 frames per second with injection of contrast were obtained. Results and conclusion: Rotating vortexes of contrast, which advanced along the wall of the aneurysm, were observed in successive images of the aneurysm cavity. The movement distance of the vortex center was measured and the results show that the vortex speed decrease after stenting. This indicates the possibility of applying the SVC method to medical imaging equipment for analysis of the flow in aneurysms containing stent.