Accuracy of Length of Virtual Stents in Treatment of Intracranial Wide-Necked Aneurysms
Accuracy of Length of Virtual Stents in Treatment of Intracranial Wide-Necked Aneurysms
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DOI：
10.1007/s00270-019-02230-9
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发表时间：
2019-05
影响因子：
2.9
通讯作者：
K. Nishimura;K. Otani;A. Mohamed;C. Dahmani;T. Ishibashi;I. Yuki;S. Kaku;H. Takao;Y. Murayama
中科院分区：
文献类型：
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作者：
K. Nishimura;K. Otani;A. Mohamed;C. Dahmani;T. Ishibashi;I. Yuki;S. Kaku;H. Takao;Y. Murayama
背景和目的精确的支架展开对于支架辅助弹簧圈栓塞术（SAC）成功治疗颅内动脉瘤至关重要。我们评估了使用商业支架规划软件生成的虚拟支架的准确性，通过比较虚拟和实际部署的颅内激光切割支架的长度在三维数字减影血管造影（3D-DSA）images.MethodsWe回顾性分析了75例连续的数据与SAC技术使用激光切割支架治疗的颅内宽颈动脉瘤。基于C形臂CT采集的3D-DSA图像，通过商业软件应用程序模拟术中支架尺寸和放置。通过测量融合术前和术后3D-DSA图像上虚拟和实际展开支架终点之间的近端差异来估计支架长度差异。手动最小化远端支架终点之间的差异。应用Kruskal-Wallis检验来检验支架位置、类型和长度是否对虚拟和真实的stents.ResultsThe虚拟和真实的stents. ResultsThe长度的中位数差异为1.58 mm，四分位数间距为1.12-2.12 mm。没有证据表明支架位置的影响（p= 0.23），支架类型（p= 0.33），或支架长度（p= 0.53）在虚拟和真实的支架之间的长度差异上。结论支架计划软件允许覆盖在血管的3D-DSA图像上的激光切割支架的3D模拟，因此可能对支架选择和在支架植入期间激光切割支架的部署有用。辅助弹簧圈栓塞颅内动脉瘤。
Background and PurposePrecise stent deployment is important for successful treatment of intracranial aneurysms by stent-assisted coiling (SAC). We evaluated the accuracy of virtual stents generated using commercial stent planning software by comparing the length of virtual and actually deployed intracranial laser cut stents on three-dimensional digital subtraction angiography (3D-DSA) images.MethodsWe retrospectively analyzed the data of 75 consecutive cases of intracranial wide-necked aneurysms treated with the SAC technique using laser cut stents. Based on 3D-DSA images acquired by C-arm CT, stent sizing and placement were intraoperatively simulated by a commercial software application. The difference in length of the stents was estimated by measuring proximal discrepancies between the end points of the virtual and actually deployed stents on fused pre-procedural and post-procedural 3D-DSA images. Discrepancies between distal stent end points were manually minimized. The Kruskal–Wallis test was applied to test whether stent location, type, and length had an effect on difference in length between virtual and real stent.ResultsThe median difference in length between virtual and real stents was 1.58 mm with interquartile range 1.12–2.12 mm. There was no evidence for an effect of stent location (p= 0.23), stent type (p= 0.33), or stent length (p= 0.53) on difference in length between virtual and real stents.ConclusionsStent planning software allows 3D simulation of laser cut stents overlain on 3D-DSA images of vessels and may thus be useful for stent selection and deployment of laser cut stents during stent-assisted coiling of intracranial aneurysms.