Head Repositioning during Neurointerventional Procedures to Optimize Biplanar Imaging.

MedStar author(s):
Citation: Journal of Neuroimaging. 2020 Jul 08PMID: 32639646Institution: MedStar Washington Hospital CenterDepartment: Neurosurgery | RadiologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2020ISSN:
  • 1051-2284
Name of journal: Journal of neuroimaging : official journal of the American Society of NeuroimagingAbstract: BACKGROUND AND PURPOSE: Head positioning is an important aspect for surgical planning in any cranial procedure. However, in neurointerventional cases, this is an afterthought due to advances in biplane imaging. We aim to present that the concept of head positioning may be applied to neurointerventional procedures to obtain optimal working projections to aide in the treatment of neurovascular pathology.CONCLUSION: In select cases, ideal views of vascular pathology can be difficult to obtain due to limitations of biplane rotation or patient-specific anatomy. Simple maneuvers in head positioning can be done to achieve better working projections for optimized endovascular treatment. Copyright (c) 2020 American Society of Neuroimaging.METHODS: The operative log of the senior author was reviewed between 2016 and 2019. Seventeen patients were identified who required readjustment of head position to allow for ideal working projection during treatment. The reports and imaging of these patients were reviewed and categorized based on repositioning adjustments applied.RESULTS: Three specific head adjustments were performed to obtain working projections using biplanar angiography: head flexed position, head extended position, or extended-tilt positioning. All patients underwent endovascular coiling treatment for a variety of intracranial aneurysms.All authors: Armonda RA, Dowlati E, Felbaum DR, Liu AH, Mai JC, Stewart J, Zhou TFiscal year: FY2021Digital Object Identifier: ORCID: Date added to catalog: 2020-08-26
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Journal Article MedStar Authors Catalog Article 32639646 Available 32639646

BACKGROUND AND PURPOSE: Head positioning is an important aspect for surgical planning in any cranial procedure. However, in neurointerventional cases, this is an afterthought due to advances in biplane imaging. We aim to present that the concept of head positioning may be applied to neurointerventional procedures to obtain optimal working projections to aide in the treatment of neurovascular pathology.

CONCLUSION: In select cases, ideal views of vascular pathology can be difficult to obtain due to limitations of biplane rotation or patient-specific anatomy. Simple maneuvers in head positioning can be done to achieve better working projections for optimized endovascular treatment. Copyright (c) 2020 American Society of Neuroimaging.

METHODS: The operative log of the senior author was reviewed between 2016 and 2019. Seventeen patients were identified who required readjustment of head position to allow for ideal working projection during treatment. The reports and imaging of these patients were reviewed and categorized based on repositioning adjustments applied.

RESULTS: Three specific head adjustments were performed to obtain working projections using biplanar angiography: head flexed position, head extended position, or extended-tilt positioning. All patients underwent endovascular coiling treatment for a variety of intracranial aneurysms.

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