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Analysis Study Research Paper | Radiology and Medical Imaging Sciences | India | Volume 13 Issue 10, October 2024 | Popularity: 5 / 10

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Comparative Analysis of Computerized Tomography Angiography and Digital Subtraction Angiography in Patients with Subarachnoid Haemorrhage due to Non-Traumatic Aneurysmal Rupture

Dr. Akansha Waghmare, Dr. Suresh A, Dr. Anasuyamma K, Dr. Swapnesh Chindhalore

Abstract: Introduction: Subarachnoid hemorrhage (SAH) typically occurs in individuals aged 45 to 60, with a prevalence of 2 to 32 cases per 100, 000 people. Approximately 70 to 80% of SAHs result from the rupture of aneurysms. Both CT angiography (CTA) and digital subtraction angiography (DSA) play crucial roles in diagnosis and treatment. However, there is a lack of comprehensive studies comparing these two techniques. This study aims to evaluate the effectiveness of CT angiography (CTA) versus digital subtraction angiography (DSA) in managing patients with aneurysmal subarachnoid hemorrhage (ASH). Aims and objectives: In this study, we retrospectively analyzed the CTA and DSA records of patients monitored for aneurysmal SAH. We measured the location and size of the aneurysms. After stabilizing, patients were transported to the DSA unit within 1 to 12 hours. We assessed the records of those who underwent DSA for diagnostic purposes involving the Anterior Communicating Artery (Ant. Com. A), Basilar Artery (BA), Middle Cerebral Artery (MCA), and Posterior Communicating Artery (Post. Com. A.). Materials and methods: In this retrospective cohort study, we evaluated the CTA and DSA records of patients treated for aneurysmal SAH at the Vydehi Institute of Medical sciences from 1st January 2023, to 30th December 2023. Data collection was conducted using the hospital's Picture Archiving and Communications System (PACS). Inclusion criteria included: spontaneous SAH, confirmed aneurysm diagnosis, hospitalization in either the intensive care unit or ward, and completion of both CTA and DSA scans. Patients with traumatic subarachnoid hemorrhage, hypertensive thalamic hemorrhage, tumoral hemorrhage, post - infarct hemorrhage, arteriovenous hemorrhages, and those with negative results on both DSA and CTA were excluded from the study. Results: Our study included a total of 60 aneurysm cases that met our inclusion criteria. Among these, 21 cases (35%) were located at the Anterior Communicating Artery (Ant. Com. A), 5 cases (8.3%) at the Basilar Artery (BA), 28 cases (46.6%) at the Middle Cerebral Artery (MCA), and 6 cases (10. %) at the Posterior Communicating Artery (Post. Com. A). When examining the alignment between DSA and CTA results based on aneurysm location, we found that 18 cases with Ant. Com. A aneurysms and 18 cases with MCA aneurysms were consistent. In contrast, 6 cases of Ant. Com. A and 14 cases of MCA aneurysms showed discrepancies (p > 0.05). Analysis of aneurysm size indicated that DSA was more sensitive for detecting aneurysms smaller than 1 cm, while both DSA and CTA exhibited similar sensitivity rates for aneurysms larger than 1 cm. Overall, no significant difference was observed between DSA and CTA in accurately identifying aneurysmal locations. Conclusion: In cases of SAH caused by aneurysms, CTA is often preferable due to its accessibility and cost - effectiveness. It does not require specially trained physicians or technicians, allows for easier monitoring with post - operative brain CT, and minimizes the need for patient referrals between healthcare facilities for diagnostic purposes. Treatment can be planned based on CTA results, making it a practical choice in these situations.

Keywords: Subarachnoid hemorrhage, Aneurysm, CT angiography, DSA

Edition: Volume 13 Issue 10, October 2024

Pages: 1321 - 1325

DOI: https://www.doi.org/10.21275/SR241018213530

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