Yang Heng, Xu Liquan, Li Yanjiang, Jiang Hanqiang, Ni Wei, Gu Yuxiang
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China.
Neurosurgical Institute, Fudan University, Shanghai 200040, China.
Brain Sci. 2023 Aug 31;13(9):1273. doi: 10.3390/brainsci13091273.
This study investigates the accuracy, stability, and safety of computer-assisted microcatheter shaping for intracranial aneurysm coiling.
Using the solid model, a microcatheter was shaped using computer-assisted techniques or manually to investigate the accuracy and delivery of microcatheter-shaping techniques in aneurysm embolization. Then, forty-eight patients were randomly assigned to the computer-assisted microcatheter-shaping (CAMS) group or the manual microcatheter-shaping (MMS) group, and the accuracy, stability, and safety of microcatheter in the patients were compared between the CAMS and MMS groups.
The speed of the successful microcatheter position was significantly faster in the CAMS group than in the MMS group (114.4 ± 23.99 s vs. 201.9 ± 24.54 s, = 0.015) in vitro. In particular for inexperienced operators, the speed of the microcatheter position with the assistance of computer software is much faster than manual microcatheter shaping (93.6 ± 29.23 s vs. 228.9 ± 31.27 s, = 0.005). In vivo, the time of the microcatheter position in the MMS group was significantly longer than that in the CAMS group (5.16 ± 0.46 min vs. 2.48 ± 0.32 min, = 0.0001). However, the mRS score at discharge, the 6-month follow-up, and aneurysm regrowth at the 6-month follow-up were all similar between the groups.
Computer-assisted microcatheter shaping is a novel and safe method for microcatheter shaping that introduces higher accuracy in microcatheter shaping during the treatment of intracranial aneurysms.
Endovascular coiling of intracranial aneurysms can be truly revolutionized through computer assistance, which could improve the endovascular treatment of aneurysms.
本研究调查计算机辅助微导管塑形用于颅内动脉瘤栓塞的准确性、稳定性和安全性。
使用实体模型，采用计算机辅助技术或手动方式对微导管进行塑形，以研究微导管塑形技术在动脉瘤栓塞中的准确性和输送情况。然后，将48例患者随机分为计算机辅助微导管塑形（CAMS）组或手动微导管塑形（MMS）组，比较CAMS组和MMS组患者微导管的准确性、稳定性和安全性。
在体外，CAMS组微导管成功到位的速度明显快于MMS组（114.4±23.99秒对201.9±24.54秒，P = 0.015）。特别是对于经验不足的操作者，借助计算机软件时微导管到位的速度比手动微导管塑形快得多（93.6±29.23秒对228.9±31.27秒，P = 0.005）。在体内，MMS组微导管到位的时间明显长于CAMS组（5.16±0.46分钟对2.48±0.32分钟，P = 0.0001）。然而，两组在出院时的改良Rankin量表（mRS）评分、6个月随访时的评分以及6个月随访时的动脉瘤复发情况均相似。
计算机辅助微导管塑形是一种新颖且安全的微导管塑形方法，在颅内动脉瘤治疗过程中能提高微导管塑形的准确性。
计算机辅助可真正革新颅内动脉瘤的血管内栓塞治疗，从而改善动脉瘤的血管内治疗。
