ABSTRACT
PURPOSE: To determine the minimum required guiding catheter length for embolization of various intracranial aneurysms in anterior circulation and to analyze the effect of various patient factors on the required catheter length and potential interaction with its stability. MATERIALS AND METHODS: From December 2016 to March 2017, 90 patients with 93 anterior circulation aneurysms were enrolled. Three types of guiding catheters (Envoy, Envoy DA, and Envoy DA XB; Codman Neurovascular, Raynham, MA, USA) were used. We measured the in-the-body length of the catheter and checked the catheter tip location in the carotid artery. We analyzed factors affecting the in-the-body length and stability of the guiding catheter system. RESULTS: The average (±standard deviation) in-the-body length of the catheter was 84.2±5.9 cm. The length was significantly longer in men (89.1±5.6 vs. 82.1±4.6 cm, P<0.001), patients older than 65 years (87.7±7.8 vs. 82.7±4.2 cm, P<0.001), patients with a more tortuous arch (arch type 2 and 3) (87.5±7.4 vs. 82.7±4.4 cm, P<0.001), and patients with a distal aneurysm location (distal group) (86.2±5.0 vs. 82.7±6.1 cm, P=0.004). A shift in the tip location was noted in 19 patients (20.4%); there was no significant different among the 3 catheters (P=0.942). CONCLUSION: The minimum required length of a guiding catheter was 84 cm on average for elective anterior-circulation aneurysm embolization. The length increased in men older than 65 years with a more tortuous arch. We could reach a higher position with distal access catheters with little difference in the stability once we reached the target location.
Subject(s)
Humans , Male , Aneurysm , Carotid Arteries , Catheters , Intracranial AneurysmABSTRACT
PURPOSE: We analyzed factors related to quality of photographs taken at neuroangiographic suites to optimize exposure condition. MATERIALS AND METHODS: We used a camera (EOS-300D, Canon Inc., Tokyo) with a standard- (EF-S 18-55 mm F3.5-5.6 USM, Canon Inc., Tokyo) and a macro-lens (EF 100 mm f/2.8 Macro USM, Canon Inc., Tokyo). Photographs were taken at a light-booth (1000 lux) and 2 neuroangiographic suites (988 and 856 lux) under ordinary intensity of illumination. We took photographs of a test chart (ColorChecker, X-rite, Michigan) and Kodak Q-13 Grey Scale Card at different values of aperture and shutter speed with fixed ISO of 400 and assessed the quality of photographs by Blade Pro (V1.1, Image group, Seoul). We analyzed photographs of a device at 1/25-1/80 shutter speed and F12 - 20 apertures and compared the result and also made visual assessment. RESULTS: Photographs of test chart and Grey Scale Card revealed that the best images chosen by Blade Pro were distributed in scattered range of quality which could help understand the range of optimum exposure condition but was not suitable for practical usage. We obtained reasonable quality photograph at shutter speed of 1/40 and aperture of F16 that can be used in 3 places. CONCLUSION: The most appropriate exposure condition when taking photographs in neuroangiographic suites could be explored. To get an optimal image in limited illumination, it is mandatory to select a fast enough shutter speed to avoid motion artifacts and a sufficient aperture to actualize the subject depth.