Comparison of computerized tomography angiography and digital subtraction angiography in aneurysmal subarachnoid hemorrhage

Şeyho Cem Yücetaş; Hakan Kaya; Safiye Kafadar; Süleyman Kılınç; İrem Karataş; Hüseyin Kafadar

doi:10.28982/josam.786971

Authors

Şeyho Cem Yücetaş Department of Neurosurgery, Adiyaman University Education and Research Hospital, Adiyaman, Turkiye https://orcid.org/0000-0002-2891-1805
Hakan Kaya Department of Cardiology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey https://orcid.org/0000-0002-5925-5150
Safiye Kafadar Department of Radiology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey https://orcid.org/0000-0003-4070-9615
Süleyman Kılınç Department of Neurosurgery, Adiyaman Education and Research Hospital, Adiyaman, Turkiye https://orcid.org/0000-0001-6421-724X
İrem Karataş Medical Faculty https://orcid.org/0000-0001-7808-4978
Hüseyin Kafadar https://orcid.org/0000-0002-6844-7517

DOI:

https://doi.org/10.28982/josam.786971

Keywords:

Subarachnoid hemorrhage, Aneurysm, CT angiography, DSA

Abstract

Background/Aim: A subarachnoid hemorrhage (SAH) usually occurs between the ages of 45-60 years and its prevalence is 2-32 per hundred thousand. Approximately 70-80% of SAHs develop as a result of aneurismal hemorrhage. Studies examining the two methods in the literature are insufficient. The goal of this study was to compare CT angiography (CTA) and digital subtraction angiography (DSA) in the management of patients with aneurysmal subarachnoid hemorrhage (ASH). Method: In this retrospective cohort study, the CTA and DSA records of patients who were followed up due to aneurysmal SAH were retrospectively examined. The location and size of the aneurysm were measured. The patients were transported to the DSA unit within 1-12 hours once they stabilized and the records of the patients who underwent DSA for Anterior Communicating Artery (Ant.Com.A), Basilar Artery (BA), MCA and Posterior Communicating Artery (Post.Com.A.) for diagnostic purposes were assessed. Results: Our study included a total of 69 aneurysm cases complying with our criteria. Twenty-four (34.8%) were at the Ant.Com.A, 6 (8.7%) were at the BA, 32 (46.4%) were at the MCA and 7 (10.1%) were at the Post.Com.A. When the alignment between DSA and CTA results was examined according to the location, eighteen cases with Ant.Com.A aneurysm, and eighteen cases with MCA aneurysm were coherent, while six and fourteen cases of Ant.Com.A and MCA aneurysm, respectively, were not (p>0,05). An analysis in terms of size revealed that DSA was more sensitive in patients with aneurysms <1 cm, while both DSA and CTA showed equal rates of sensitivity in aneurysms>1 cm. Overall, no significant difference was found (Ҡ=-0.075, -0.120; π= -0.107, -0.200; P=0.600) between DSA and CTA in terms of accuracy of showing aneurysmal location (Ҡ=-0.050, π= -0.076; P=0.650). Conclusion: In SAH due to aneurysms, CTA can be preferred, and treatment can be planned based on its results because it is more accessible and cheaper, does not require specially trained physicians and technicians, enables easier control of post-operative brain CT, and reduces patient referrals between health institutions for diagnostic purposes.

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