Optimal Woven EndoBridge (WEB) Device Size Selection Using Automated Volumetric Software.
Optimal Woven EndoBridge (WEB) Device Size Selection Using Automated Volumetric Software.
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DOI：
10.3390/brainsci11070901
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发表时间：
2021-07-08
期刊：
影响因子：
3.3
通讯作者：
Ortega-Gutierrez S
中科院分区：
文献类型：
--
作者：
Ansari S;Zevallos CB;Farooqui M;Dajles A;Schafer S;Quispe-Orozco D;Mendez-Ruiz A;Abdelkarim S;Dandapat S;Ortega-Gutierrez S
简介：选择适当的Woven EndoBridge（WEB）器械尺寸用于治疗宽颈分叉部动脉瘤（WNBA）仍然具有挑战性。本研究的目的是评价不同的基于容积的成像方法，以预测准确的WEB器械尺寸选择，从而成功植入。方法：纳入了2019年1月至2020年6月期间使用WEB器械治疗颅内动脉瘤的所有连续患者。使用三种不同的模式测量动脉瘤尺寸以计算动脉瘤体积：自动三维（3D）数字减影血管造影术（DSA）、手动3D DSA和二维（2D）DSA。器械-动脉瘤体积（DAV）比定义为器械体积除以动脉瘤体积。WEB体积和DAV比率用于评估器械植入成功率和6个月时的随访血管造影结局。Pearson相关性、Wilcoxon秩和检验和密度近似用于估计成功植入的WEB体积和成像模态体积。结果：共有41例患者的43个动脉瘤被纳入研究。WEB器械与动脉瘤体积相关系数最高的是3D自动测量（r = 0.943），其次是3D手动测量（r = 0.919）和2D DSA测量（r = 0.882）。3D自动和2D DSA的测量中值体积显著不同（p = 0.017）。在0.6 ~ 0.8DAV范围内种植成功率最高（87.5%）。结论：术前评估DAV比率可提高WEB器械植入成功率。我们的研究结果表明，体积测量，特别是使用动脉瘤的自动3D体积，可以帮助准确的WEB设备尺寸选择。
Introduction: Selecting the appropriate Woven EndoBridge (WEB) device sizing for the treatment of wide-neck bifurcation aneurysms (WNBAs) remains challenging. The aim of this study was to evaluate different volumetric-based imaging methodologies to predict an accurate WEB device size selection to result in a successful implantation. Methods: All consecutive patients treated with WEB devices for intracranial aneurysms from January 2019 to June 2020 were included. Aneurysm dimensions to calculate aneurysm volumes were measured using three different modalities: automated three-dimensional (3D) digital subtraction angiography (DSA), manual 3D DSA, and two-dimensional (2D) DSA. The device–aneurysm volume (DAV) ratio was defined as device volume divided by the aneurysm volume. WEB volumes and the DAV ratios were used for assessing the device implantation success and follow-up angiographic outcomes at six months. Pearson correlation, Wilcoxon Rank Sum test, and density approximations were used for estimating the WEB volumes and the imaging modality volumes for successful implantation. Results: A total of 41 patients with 43 aneurysms were included in the study. WEB device and aneurysm volume correlation coefficient was highest for 3D automatic (r = 0.943), followed by 3D manual (r = 0.919), and 2D DSA (r = 0.882) measurements. Measured median volumes were significantly different for 3D automatic and 2D DSA (p = 0.017). The highest rate of successful implantation (87.5%) was between 0.6 and 0.8 DAV ratio. Conclusion: Pre-procedural assessment of DAV ratios may increase WEB device implantation success. Our results suggest that volumetric measurements, especially using automated 3D volumes of the aneurysms, can assist in accurate WEB device size selection.
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