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Image Search Results


Fusion-guided endovascular attempt, iatrogenic perforation, and coil embolization . (A) Digital subtraction angiography (DSA) confirms RICA occlusion from C4 to C6; three-dimensional (3D) rotational images were obtained. Under general anesthesia, a 6 F guiding catheter (Envoy, Cordis) was positioned at C1, and a 0.014-inch Synchro-14 microwire (200 cm; Stryker) with a microcatheter (Excelsior SL-10, Boston Scientific) was advanced coaxially. (B–D2) A 3D MRI–DSA fusion overlay served as an adjunct roadmap overlay supporting navigation planning and intra-procedural orientation during traversal through C4–C5. (D5) Mismatch with the fusion overlay prompted early suspicion of wire deviation beyond the virtual arterial wall while attempting to cross C6. (D6) Microcatheter contrast injection demonstrates subarachnoid extravasation (“storm cloud” sign), confirming perforation. (D7, D8) Two detachable coils (Guglielmi Detachable Coils, 4 mm × 8 cm and 3 mm × 6 cm) were deployed at C6, achieving hemostasis. (E–G) Post-procedural non-contrast CT reveals subarachnoid hemorrhage in the bilateral occipital lobes and along the tentorium, which resolved on days 1–2. The patient was discharged on aspirin 300 mg daily (indefinite) and clopidogrel 75 mg daily (3 months), with no recurrent symptoms at 3-month follow-up.

Journal: European Journal of Radiology Open

Article Title: Preliminary results of 3D MRI-DSA fusion for navigation planning in endovascular recanalization of chronic intracranial artery occlusion

doi: 10.1016/j.ejro.2026.100742

Figure Lengend Snippet: Fusion-guided endovascular attempt, iatrogenic perforation, and coil embolization . (A) Digital subtraction angiography (DSA) confirms RICA occlusion from C4 to C6; three-dimensional (3D) rotational images were obtained. Under general anesthesia, a 6 F guiding catheter (Envoy, Cordis) was positioned at C1, and a 0.014-inch Synchro-14 microwire (200 cm; Stryker) with a microcatheter (Excelsior SL-10, Boston Scientific) was advanced coaxially. (B–D2) A 3D MRI–DSA fusion overlay served as an adjunct roadmap overlay supporting navigation planning and intra-procedural orientation during traversal through C4–C5. (D5) Mismatch with the fusion overlay prompted early suspicion of wire deviation beyond the virtual arterial wall while attempting to cross C6. (D6) Microcatheter contrast injection demonstrates subarachnoid extravasation (“storm cloud” sign), confirming perforation. (D7, D8) Two detachable coils (Guglielmi Detachable Coils, 4 mm × 8 cm and 3 mm × 6 cm) were deployed at C6, achieving hemostasis. (E–G) Post-procedural non-contrast CT reveals subarachnoid hemorrhage in the bilateral occipital lobes and along the tentorium, which resolved on days 1–2. The patient was discharged on aspirin 300 mg daily (indefinite) and clopidogrel 75 mg daily (3 months), with no recurrent symptoms at 3-month follow-up.

Article Snippet: Fusion-guided endovascular recanalization and outcome . (A) Three-dimensional (3D) rotational DSA of the LICA under general anesthesia. (B, C) MRI–DSA fusion generates patient-specific overlays of the LICA, MCA, and ACA. (D) The fused overlay is superimposed on live fluoroscopy as an adjunct roadmap supporting navigation planning and intra-procedural orientation. (E) After multiple attempts, a 0.014-inch Synchro-14 microwire (200 cm; Stryker) and microcatheter (Excelsior SL-10, Boston Scientific, USA) traverse the C7 occlusion. (F1, F2) Following balloon angioplasty (Gateway 2.0 × 15 mm balloon Stryker Neurovascular, USA) and stent (Enterprise 2.25 × 10 mm Codman Neurovascular, USA) implantation, final DSA confirms complete LICA recanalization (TICI grade 3).

Techniques: Injection

Fusion-guided endovascular recanalization and outcome . (A) Three-dimensional (3D) rotational DSA of the LICA under general anesthesia. (B, C) MRI–DSA fusion generates patient-specific overlays of the LICA, MCA, and ACA. (D) The fused overlay is superimposed on live fluoroscopy as an adjunct roadmap supporting navigation planning and intra-procedural orientation. (E) After multiple attempts, a 0.014-inch Synchro-14 microwire (200 cm; Stryker) and microcatheter (Excelsior SL-10, Boston Scientific, USA) traverse the C7 occlusion. (F1, F2) Following balloon angioplasty (Gateway 2.0 × 15 mm balloon Stryker Neurovascular, USA) and stent (Enterprise 2.25 × 10 mm Codman Neurovascular, USA) implantation, final DSA confirms complete LICA recanalization (TICI grade 3). The patient was discharged on aspirin 100 mg daily (indefinitely) and clopidogrel 75 mg daily (3 months). At 3-month follow-up, DSA demonstrates durable LICA patency with no recurrent neurological symptoms.

Journal: European Journal of Radiology Open

Article Title: Preliminary results of 3D MRI-DSA fusion for navigation planning in endovascular recanalization of chronic intracranial artery occlusion

doi: 10.1016/j.ejro.2026.100742

Figure Lengend Snippet: Fusion-guided endovascular recanalization and outcome . (A) Three-dimensional (3D) rotational DSA of the LICA under general anesthesia. (B, C) MRI–DSA fusion generates patient-specific overlays of the LICA, MCA, and ACA. (D) The fused overlay is superimposed on live fluoroscopy as an adjunct roadmap supporting navigation planning and intra-procedural orientation. (E) After multiple attempts, a 0.014-inch Synchro-14 microwire (200 cm; Stryker) and microcatheter (Excelsior SL-10, Boston Scientific, USA) traverse the C7 occlusion. (F1, F2) Following balloon angioplasty (Gateway 2.0 × 15 mm balloon Stryker Neurovascular, USA) and stent (Enterprise 2.25 × 10 mm Codman Neurovascular, USA) implantation, final DSA confirms complete LICA recanalization (TICI grade 3). The patient was discharged on aspirin 100 mg daily (indefinitely) and clopidogrel 75 mg daily (3 months). At 3-month follow-up, DSA demonstrates durable LICA patency with no recurrent neurological symptoms.

Article Snippet: Fusion-guided endovascular recanalization and outcome . (A) Three-dimensional (3D) rotational DSA of the LICA under general anesthesia. (B, C) MRI–DSA fusion generates patient-specific overlays of the LICA, MCA, and ACA. (D) The fused overlay is superimposed on live fluoroscopy as an adjunct roadmap supporting navigation planning and intra-procedural orientation. (E) After multiple attempts, a 0.014-inch Synchro-14 microwire (200 cm; Stryker) and microcatheter (Excelsior SL-10, Boston Scientific, USA) traverse the C7 occlusion. (F1, F2) Following balloon angioplasty (Gateway 2.0 × 15 mm balloon Stryker Neurovascular, USA) and stent (Enterprise 2.25 × 10 mm Codman Neurovascular, USA) implantation, final DSA confirms complete LICA recanalization (TICI grade 3).

Techniques: