CE-MRA for follow-up of aneurysms post stent-assisted coiling

Interv Neuroradiol. 2012 Sep;18(3):275-83. doi: 10.1177/159101991201800305. Epub 2012 Sep 10.


This study compared the accuracy of contrast-enhanced MR angiography (CE-MRA) to intra-arterial cerebral angiography (IA-DSA) for assessment of intracranial aneurysms after stent-assisted coiling and to check if the presence of a stent in the parent artery diminishes the accuracy of CE-MRA. Consecutive patients with cerebral aneurysms treated by stent-assisted coiling were evaluated retrospectively. Matching follow-up CE-MRA and IA-DSA were evaluated separately. Evaluation included the presence of aneurysmal remnant, patency and stenosis of parent artery. Twenty-seven patients with 28 aneurysms and 33 matched CE-MRA and IA-DSA studies were evaluated. Nineteen aneurysmal remnants were seen on CE-MRA and 16 on IA-DSA. CE-MRA diagnosed three aneurysmal remnants not appreciated on IA-DSA. Five other remnants were larger on CE-MRA than IA-DSA. None of the remnants were missed on CE-MRA. Parent arteries were patent on both modalities. CE-MRA showed false stenosis of the stented artery in six cases and exaggerated stenosis in two. In 18 cases, CE-MRA showed a short focal "pseudo-stenosis" where the stent's marker bands were located. This was noted whenever the stent's marker bands were located in an artery with luminal diameter ≤2 mm and was called "marker band effect". CE-MRA is an accurate technique for follow-up of aneurysms post stent-assisted coiling with excellent depiction of remnants in spite of the presence of a stent. Apparent stenosis of the stented parent artery on CE-MRA is often false or exaggerated. "Marker band effect" should be recognized as an artifact that appears when stent's marker bands are in a small artery.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Cerebral Angiography / methods*
  • Contrast Media
  • Embolization, Therapeutic / methods*
  • Female
  • Humans
  • Intracranial Aneurysm / diagnosis*
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / therapy*
  • Iohexol
  • Magnetic Resonance Angiography / methods*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stents*
  • Treatment Outcome
  • Vascular Patency


  • Contrast Media
  • Iohexol