In neurovascular care, clinicians must quickly make critical decisions and perform intricate procedures based on the anatomical information available to them. It has now become essential to be able to visualize complex cerebrovascular structures and pathologies in three dimensions. As we'll explore in this blog, 3D imaging plays a crucial role in providing the detailed insights needed to elevate confidence, streamline workflows and deliver the highest level of care for patients facing potentially life-threatening neurovascular conditions.
One of the key advantages of 3D imaging is the ability to comprehensively understand intricate cerebral anatomy. As Prof. Jacques Moret, Honorary Chief of Service at Hôpital Bicêtre AP- HP in Paris, illustrates,
When you switch from one plane to two planes and then a 3D-space view, you have a clear understanding of the anatomy. And not only the anatomy, but the relationship with the environment. 3D is like being blind and coming to light.
This enhanced anatomical understanding is critical for procedures like treating cerebral aneurysms, where precisely visualizing the aneurysm's location, size, neck and relationship to surrounding vessels is paramount. Dr. Jildaz Caroff, Interventional Neuroradiologist at Hôpital Bicêtre AP-HP, emphasizes,
I trust and base my treatments on 3D measurements – because we live in a 3D world, and it's 3D anatomy. So, I need the perspective and understanding that is brought by 3D.
Advanced imaging capabilities, such as those provided by Philips SmartCT Angio, enable clinicians to obtain high-resolution volumetric views of vascular anatomy from a single rotational angiography run – all controlled via touchscreen, right at tableside. This efficient 3D visualization helps unravel anatomical complexities to support confident treatment planning and device sizing decisions.
During neurovascular interventions, 3D imaging also plays a vital role in guiding devices and implants through tortuous vasculature to the target site. Real-time 3D guidance tools like SmartCT Roadmap dynamically update position changes, providing an intuitive 3D map to support precise navigation of guidewires, catheters and devices through cerebral vessels while managing radiation exposure.
For aneurysm treatment with new flow-diverting stents and intrasaccular devices, 3D image guidance is especially valuable for achieving accurate positioning and deployment in the context of the parent vessel, aneurysm neck and sac. Dr. Gregory Gascou, Interventional Neuroradiologist at Centre Hospitalier Universitaire de Montpellier, explains,
We always use 3D images in the case of treating aneurysms or arteriovenous malformations (AVMs), because it allows us to have a good appreciation of the anatomy of the aneurysm, of the proximal artery and distal arteries. It allows us to choose the best devices for the treatment, and without 3D imaging, you increase the risk of complications.
High-resolution 3D tools like Philips SmartCT can be used to confirm proper stent placement and check for possible arterial dissections while a patient is still on the table, enabling any necessary adjustments to be made immediately. This peri- procedural 3D assessment promotes optimal treatment results and patient safety.
In acute ischemic stroke interventions, "time is brain" and streamlined workflows are critical. 3D image technology at the tableside can accelerate stroke triage and treatment decisions. For example, comprehensive stroke analysis can be performed using subtraction-free SmartCT Soft Tissue scans – revealing early ischemic changes, localizing occlusions, and assessing collateral filling and tissue viability.
Paired with innovative workflow tools, this approach can allow stroke teams to go directly to the angio suite and obtain all necessary diagnostic information there, dramatically reducing the time to treatment. Clinical studies have shown that this "Direct-to-Angio Suite" protocol can result in faster recanalization times and potentially improve functional outcomes for stroke patients.1
Now that 3D is fully doable and manageable inside the angio suite, I think it's a big push for other people to use 3D in a very concrete fashion in the angio suite
3D image technology has become indispensable in modern neurovascular care, enabling clinicians to see more, know more and do more for their patients. With advanced 3D acquisition, visualization and guidance tools at their fingertips, neurointerventionalists can unravel complex anatomy, navigate confidently to target pathologies, and make real-time treatment assessments to support the best possible patient outcomes. By enhancing diagnostic insights, improving procedural precision and streamlining acute stroke care, 3D technologies are empowering a new era of innovation and progress in neurovascular intervention.
I will not feel safe doing my treatment if I do not use [3D imaging]," says Prof. Costalat. "The working view understanding, the final anatomy understanding, is key for the safety of the treatment.
As a global leader in image-guided therapy and neurovascular solutions, Philips is committed to delivering cutting-edge technologies like the Azurion image-guided therapy system and SmartCT visualization tools to help clinicians perform at their best. Our integrated systems and advanced software put the power of 3D in your hands – whether you're facing a complex aneurysm or racing against the clock to treat an ischemic stroke.
We invite you to partner with us in bringing new levels of confidence and precision to neurovascular care, so you can focus on what matters most: achieving life-changing results for your patients. Discover the potential of the Philips Neuro suite.