How is 3D angiography performed?
A relatively long injection is performed (e.g. over 6 seconds) while the C-arm rotates around the patient's head ~180 degrees. Prior to the injection the same rotation is performed so that a subtraction mask can be obtained. The non-contrast image is then subtracted from the enhanced image and the acquired images are manipulated in a similar fashion to CT to generate a 3D model of the arterial circulation.
Via a right groin approach (5 F sheath) bilateral CCA and left vertebral artery angiography was performed, with 3 D rotational angiography of the left CCA. (only left ICA injections shown)
A peanut shaped ACOM aneurysm fills from the left CCA runs. It points anterolaterally to the right. It measures 12.5mm in its longest axis, 5.5mm across the body with a 5.5mm neck. Both A2 origins arise from the aneurysm base. Right A1 of good calibre.