Imaging of the Contour Neurovascular System with Photon-counting CT Angiography

The Contour Neurovascular System (CNS) is an intrasaccular flow-disrupting device for treating intracranial aneurysms. Conventional follow-up imaging of the CNS with MR angiography or conventional CT angiography often suffers from significant artifacts. Photon-counting CT angiography (PCCTA) is a novel technique offering superior spatial resolution and reduced beam-hardening artifacts.

We report one of the first cases of a 48-year-old patient with an anterior communicating artery aneurysm treated with a CNS who underwent follow-up imaging with PCCTA. The examination provided markedly artifact-reduced images, enabling clear visualization of the CNS, complete aneurysm occlusion, and adjacent vessel patency. Compared with MR angiography, PCCTA offered substantially improved depiction of the device itself, highlighting its unique value for precise, non-invasive follow-up of intracranial neurovascular implants and its potential as an alternative for detailed post-procedural assessment of the CNS.