使用AneuShape™软件进行颅内动脉瘤栓塞术中微导管塑形的虚拟模拟：一项验证研究。

Virtual simulation with AneuShape™ software for microcatheter shaping in intracranial aneurysm coiling: a validation study.

作者信息

Wu Zeng-Bao, Zeng Ying, Zhang Hua-Qiu, Shu Kai, Li Gao-Hui, Xiang Jian-Ping, Lei Ting, Zhu Ming-Xin

机构信息

Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

ArteryFlow Technology Co., Ltd., Hangzhou, Zhejiang, China.

出版信息

Front Neurol. 2023 Apr 26;14:1095266. doi: 10.3389/fneur.2023.1095266. eCollection 2023.

DOI:10.3389/fneur.2023.1095266

PMID:37181546

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10169654/

Abstract

BACKGROUND

The shaping of an accurate and stable microcatheter plays a vital role in the successful embolization of intracranial aneurysms. Our study aimed to investigate the application and the role of AneuShape™ software in microcatheter shaping for intracranial aneurysm embolization.

METHODS

From January 2021 to June 2022, 105 patients with single unruptured intracranial aneurysms were retrospectively analyzed with or without AneuShape™ software to assist in microcatheter shaping. The rates of microcatheter accessibility, accurate positioning, and stability for shaping were analyzed. During the operation, fluoroscopy duration, radiation dose, immediate postoperative angiography, and procedure-related complications were evaluated.

RESULTS

Compared to the manual group, aneurysm-coiling procedures involving the AneuShape™ software exhibited superior results. The use of the software resulted in a lower rate of reshaping microcatheters (21.82 vs. 44.00%, = 0.015) and higher rates of accessibility (81.82 vs. 58.00%, = 0.008), better positioning (85.45 vs. 64.00%, = 0.011), and higher stability (83.64 vs. 62.00%, = 0.012). The software group also required more coils for both small (<7 mm) and large (≥7 mm) aneurysms compared to the manual group (3.50 ± 0.19 vs. 2.78 ± 0.11, = 0.008 and 8.22 ± 0.36 vs. 6.00 ± 1.00, = 0.081, respectively). In addition, the software group achieved better complete or approximately complete aneurysm obliteration (87.27 vs. 66.00%, = 0.010) and had a lower procedure-related complication rate (3.60 vs. 12.00%, = 0.107). Without this software, the operation had a longer intervention duration (34.31 ± 6.51 vs. 23.87 ± 6.98 min, < 0.001) and a higher radiation dose (750.50 ± 177.81 vs. 563.53 ± 195.46 mGy, < 0.001).

CONCLUSIONS

Software-based microcatheter shaping techniques can assist in the precise shaping of microcatheters, reduce operating time and radiation dose, improve embolization density, and facilitate more stable and efficient intracranial aneurysm embolization.

摘要

背景

精确且稳定的微导管塑形对于颅内动脉瘤栓塞术的成功起着至关重要的作用。我们的研究旨在探讨AneuShape™软件在颅内动脉瘤栓塞术微导管塑形中的应用及作用。

方法

回顾性分析2021年1月至2022年6月期间105例单发未破裂颅内动脉瘤患者，这些患者接受了有无AneuShape™软件辅助的微导管塑形。分析微导管的可达性、精确定位及塑形稳定性的发生率。术中评估透视时间、辐射剂量、术后即刻血管造影及与手术相关的并发症。

结果

与手动组相比，使用AneuShape™软件的动脉瘤栓塞手术效果更佳。使用该软件导致微导管重塑率更低（21.82%对44.00%，P = 0.015），可达率更高（81.82%对58.00%，P = 0.008），定位更好（85.45%对64.00%，P = 0.011），稳定性更高（83.64%对62.00%，P = 0.012）。与手动组相比，软件组对于小（<7 mm）和大（≥7 mm）动脉瘤均需要更多的弹簧圈（分别为3.50±0.19对2.78±0.11，P = 0.008；8.22±0.36对6.00±1.00，P = 0.081）。此外，软件组实现了更好的动脉瘤完全或近乎完全闭塞（87.27%对66.00%，P = 0.010），且与手术相关的并发症发生率更低（3.60%对12.00%，P = 0.107）。没有该软件时，手术干预时间更长（34.31±6.51对23.87±6.98分钟，P<0.001），辐射剂量更高（750.50±177.81对563.53±195.46 mGy，P<0.001）。