Semi-automated measurement of vascular tortuosity and its implications for mechanical thrombectomy performance
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INTERVENTIONAL NEURORADIOLOGY
Semi-automated measurement of vascular tortuosity and its implications for mechanical thrombectomy performance Maxim Mokin 1 & Muhammad Waqas 2,3 & Felix Chin 2,3 & Hamid Rai 2,3 & Jillian Senko 4 & Adam Sparks 4 & Richard W. Ducharme 4 & Michael Springer 4 & Cesario V. Borlongan 1 & Elad I. Levy 2,3 & Ciprian Ionita 5 & Adnan H. Siddiqui 2,3 Received: 21 April 2020 / Accepted: 13 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Few studies have examined the geometry of endovascular mechanical thrombectomy pathways. Here we examine the tortuosity and angulations of catheter pathways from the aortic arch to the termination of the internal carotid artery (ICA) and its association with thrombectomy performance. Methods We included 100 consecutive anterior circulation large vessel occlusion thrombectomy patients over 12 months. Computed tomography angiograms (CTA) were used for 3D segmentation of catheter pathway from the aortic arch to ICA termination. Tortuosity index (TI) and angulations of the catheter pathway were measured in a semi-automated fashion. TI and angulation degree were compared between sides and correlated with age and procedural measures. Results We analyzed 188 catheter pathways in 100 patients. Severe angulation (≤ 30°) was present in 5.8% and 39.4% of common carotid artery (CCA) and extracranial ICA segments, respectively. Five pathways (2.6%) had 360° loop. CCA and extracranial ICA tortuosity had a weak but significant correlation with age (r = 0.17, 0.21, p value = 0.05, 0.02 respectively), time from groin puncture to the site of occlusion (r = 0.29, 0.25, p values = 0.008, 0.026 respectively), and fluoroscopy time (r = 0.022, 0.31, p values = 0.016, 0.001 respectively). There was a significant Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00234-020-02525-6) contains supplementary material, which is available to authorized users. * Adnan H. Siddiqui [email protected]
Cesario V. Borlongan [email protected]
Maxim Mokin [email protected]
Elad I. Levy [email protected]
Muhammad Waqas [email protected] Felix Chin [email protected]
Ciprian Ionita [email protected] 1
Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA
2
Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, 100 High Street, Suite B4, Buffalo, NY 14203, USA
Adam Sparks [email protected]
3
Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA
Richard W. Ducharme [email protected]
4
Jacobs Institute, Buffalo, NY, USA
5
Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, USA
Hamid Rai [email protected] Jillian Senko [email protected]
Michael Springer [email protected]
Neuroradiology
difference in the pattern of angulation (p value = 0.04) and tortuosity between right and left side in CCA segment (TI = 0.20
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