Interventional Neuroradiology. Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 5, 80131, Naples, Italy.
Department of Precision Medicine, University of Campania L. Vanvitelli, Naples, NA), Italy.
Radiol Med. 2023 Apr;128(4):480-491. doi: 10.1007/s11547-023-01620-x. Epub 2023 Apr 7.
Successful endovascular treatment by stenting of intracranial aneurysms requires proper placement of the device and appropriate choice of its diameter and length. To date, several methods have been employed to achieve these goals, although each has inherent critical issues. Recently developed stent planning software applications can be used to assist interventional neuroradiologists. Based on a 3D-DSA image acquired before stenting, these applications simulate and visualize the final placement of the deployed stent. In this single-centre retrospective study, 27 patients undergoing an intravascular procedure for the treatment of intracranial aneurysms from June 2019 to July 2020 were evaluated according to strict inclusion criteria. Stent virtualization was performed with Syngo 3D Aneurysm Guidance Neuro software. We compared the software-generated stent measurement and measurements taken by the interventional radiologist. Statistical analysis was performed using the STAC web platform. Mean and standard deviations of absolute and relative discrepancies between predicted and implanted stents were recorded. Friedman's nonparametric test was used to refute the null hypotheses, i.e. (I) discrepancies between the size of virtual and implanted stents would occur, and (II) operator influence does not affect the outcome of the virtual stenting process. Based on these observations, it is believed that the virtual stenting process can validly assist interventional neuroradiologists in selecting the appropriate device and reducing peri- and post-procedural complications. The results of our study suggest that virtual reality simulation of devices used for endovascular treatment of intracranial aneurysms is a useful, rapid, and accurate tool for interventional procedure planning.
颅内动脉瘤的血管内治疗需要通过支架置入术实现，这要求术者恰当放置支架并准确选择支架的直径和长度。目前，已经有多种方法可以实现这一目标，但每种方法都存在固有缺陷。最近开发的支架规划软件应用程序可以协助介入神经放射科医生。基于支架置入术前获得的 3D-DSA 图像，这些应用程序可以模拟和可视化展开后的支架最终放置位置。在这项单中心回顾性研究中，我们根据严格的纳入标准，评估了 2019 年 6 月至 2020 年 7 月期间接受血管内治疗颅内动脉瘤的 27 名患者。支架虚拟可视化是使用 Syngo 3D Aneurysm Guidance Neuro 软件进行的。我们比较了软件生成的支架测量值和介入放射科医生的测量值。使用 STAC 网络平台进行了统计学分析。记录了预测支架和植入支架之间的绝对和相对差异的平均值和标准差。采用 Friedman 非参数检验反驳零假设，即（I）虚拟和植入支架之间的尺寸差异会发生，以及（II）操作者的影响不会影响虚拟支架过程的结果。基于这些观察结果，我们认为虚拟支架过程可以有效地协助介入神经放射科医生选择合适的设备，并减少围手术期和术后并发症。我们的研究结果表明，虚拟现实模拟用于颅内动脉瘤血管内治疗的器械是介入手术计划的一种有用、快速且准确的工具。
