Initial Clinical Experience with AView-A Clinical Computational Platform for Intracranial Aneurysm Morphology, Hemodynamics, and Treatment Management.
Initial Clinical Experience with AView-A Clinical Computational Platform for Intracranial Aneurysm Morphology, Hemodynamics, and Treatment Management.
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DOI：
10.1016/j.wneu.2017.09.030
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发表时间：
2017-12
影响因子：
2
通讯作者：
Meng H
中科院分区：
文献类型：
--
作者：
Xiang J;Varble N;Davies JM;Rai AT;Kono K;Sugiyama SI;Binning MJ;Tawk RG;Choi H;Ringer AJ;Snyder KV;Levy EI;Hopkins LN;Siddiqui AH;Meng H
颅内动脉瘤（IA）的治疗具有挑战性。临床医生通常依赖于各种各样的、直觉上不同的方法来评估破裂风险，这些方法可能只是部分地考虑了复杂的血流动力学和形态学因素。我们开发了一个临床导向的、流线型的计算平台AView的原型，用于临床环境中血液动力学和形态计量学的快速评估。为了显示AView潜在的临床应用，我们报告了我们最初的多中心经验，强调了IAs形态学和血流动力学分析的可能优势。AView软件部署在8个医疗中心（6个美国，2个日本）。2012年9月至2013年1月，8名临床医生接受了培训并使用了AView软件。我们提出了12例说明AView潜在临床应用的病例。总的来说，形态学和血流动力学、血流可视化和破裂相似性评分（破裂风险的替代指标）都被提供了。在3例病例中，AView能够确认临床医生的治疗决定；3例可提示多发动脉瘤中哪些动脉瘤风险较高；在5例病例中，AView可以为模棱两可的情况的治疗决策提供额外的信息。在一个支架辅助盘绕的病例中，血流可视化预测了支架放置的直观选择可能导致由于线圈堵塞而导致大脑前动脉的牺牲，并导致临床医生重新考虑治疗方案。AView具有确定IAs治疗决策的潜力，建议在多个动脉瘤中治疗哪一个，并指导治疗决策。此外，它提供的血流可视化可以为动脉瘤治疗计划提供信息，并可能避免不良结果。
Intracranial aneurysm (IA) management is challenging. Clinicians often rely on varied and intuitively disparate ways of evaluating rupture risk that may only partially take into account complex hemodynamic and morphologic factors. We developed a prototype of a clinically-oriented, streamlined, computational platform, AView, for rapid assessment of hemodynamics and morphometrics in clinical settings. To show the potential clinical utility of AView, we report our initial multicenter experience highlighting the possible advantages of morphologic and hemodynamic analysis of IAs. AView software was deployed across 8 medical centers(6 US, 2 Japan). Eight clinicians were trained and used the AView software between September 2012 and January 2013. We present 12 illustrative cases that show the potential clinical utility of AView. For all, morphology and hemodynamics, flow visualization, and rupture resemblance score(a surrogate for rupture risk) were provided. In 3 cases, AView could confirm the clinicians’ decision to treat; in 3 cases, it could suggest which aneurysms may be at higher risk among multiple aneurysms; in 5 cases, AView could provide additional information for use during treatment decisions for ambiguous situations. In one stent-assisted coiling case, flow visualization predicted that the intuitive choice for stent placement could have resulted in sacrifice of an anterior cerebral artery due to blockage by coils and led clinicians to reconsider treatment plans. AView has the potential to confirm decisions to treat IAs, suggest which among multiple aneurysms to treat, and guide treatment decisions. Furthermore, the flow visualization it affords can inform aneurysm treatment planning and potentially avoid poor outcomes.
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影响因子：
4.1
作者：
ROPPER, AH;ZERVAS, NT
通讯作者：
ZERVAS, NT
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DOI：
10.1115/1.4023382
发表时间：
2013-02-01
影响因子：
1.7
作者：
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通讯作者：
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影响因子：
8.3
作者：
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影响因子：
24
作者：
Norgaard, Bjarne L.;Leipsic, Jonathon;Achenbach, Stephan
通讯作者：
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影响因子：
8.3
作者：
Kelly, PJ;Stein, J;Furie, KL
通讯作者：
Furie, KL