Role of Multislice Computerized Tomographic Angiography after Clip Placement in Aneurysm Patients Based on Comparison with Three Dimensional Digital Subtraction Angiography

Postoperative angiography for aneurysm surgery is essential in identifying those aneurysms that have been inadequately clipped, allowing for additional corrective surgery. The current standard of reference for the postoperative evaluation of clipped aneurysms is digital subtraction angiography (DSA). However, DSA is an invasive method requiring arterial puncture and intraarterial catheter manipulation and has a total complication rate of approximately 5% and a permanent stroke rate of approximately 0.5% to 1%. These complications limit the clinical application of DSA and therefore there is a great demand for a non-invasive screening study to evaluate clipped aneurysms. Recently, multislice computerized tomographic angiography (MCTA) was developed to provide clear vascular images, and it is being widely used in the neurovascular field as MCTA does not carry the risks of DSA and takes less time than DSA. To determine whether postoperative MCTA can replace postoperative DSA, we evaluated the accuracy of MCTA in the postoperative evaluation of clipped aneurysms by comparising it to postoperative three dimensional (3D)-DSA.