Muñoz Romina, Dazeo Nicolás, García Camila, Janot Kevin, Bankole Nourou Dine Adeniran, Narata Ana Paula, Rouchaud Aymeric, Larrabide Ignacio
Instituto PLADEMA - CONICET, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina.
Instituto PLADEMA - CONICET - CNEA, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina.
Interv Neuroradiol. 2025 Jan 28:15910199251316411. doi: 10.1177/15910199251316411.
WEB shape modification has been analyzed in relation to the aneurysm occlusion outcome and techniques have been presented with one-dimensional measurements of the device to quantify the change after implantation. In this work, we present an analysis of pre-treatment vascular morphology and hemodynamics of cases treated with WEB devices, which were three-dimensionally quantified in morphology and position to detect modifications.
Seventeen WEB-treated aneurysms with pre-treatment, post-treatment and follow-up 3D flat-panel CT were included. Three-dimensional measurements of the WEB morphology and position were made at post-treatment and at follow-up. Differences between acquisitions of all measured variables were statistically evaluated (Wilcoxon signed-rank paired test, -value = 0.05). Pre-treatment aneurysm angles were three-dimensionally measured and CFD simulations were performed to evaluate the influence of flow on WEB changes.
WEB height and diameter presented statistically significant changes. Modification of the angle between the WEB axis and parent artery was significantly higher in the group with WEB shape modification (Mann-Whitney U test, < 0.05). In this group, the median pre-treatment aneurysm angle was smaller than in the group without shape modification (8.16° vs. 13.14°, = 0.06). Inflow ratio was higher in the WEB shape modification group.
An association between the magnitude of morphological changes of the WEB with the direction of its axis within the aneurysm was found. The analysis of pre-treatment morphological and hemodynamic conditions would allow the detection of aneurysm cases in which the WEB will undergo a more pronounced modification.
已针对动脉瘤闭塞结果分析了WEB形状改变情况，并提出了通过对装置进行一维测量来量化植入后变化的技术。在本研究中，我们对接受WEB装置治疗的病例的治疗前血管形态和血流动力学进行了分析，对其形态和位置进行了三维量化以检测变化情况。
纳入17例接受WEB治疗的动脉瘤病例，这些病例有治疗前、治疗后及随访的三维平板CT图像。在治疗后和随访时对WEB的形态和位置进行三维测量。对所有测量变量的采集数据差异进行统计学评估（Wilcoxon符号秩配对检验，P值 = 0.05）。对治疗前动脉瘤角度进行三维测量，并进行计算流体动力学（CFD）模拟以评估血流对WEB变化的影响。
WEB的高度和直径呈现出具有统计学意义的变化。在WEB形状发生改变的组中，WEB轴与母动脉之间角度的改变明显更大（Mann-Whitney U检验，P < 0.05）。在该组中，治疗前动脉瘤角度的中位数小于未发生形状改变的组（8.16° 对 13.14°，P = 0.06）。WEB形状改变组的流入比率更高。
发现了WEB形态学变化的程度与其在动脉瘤内的轴方向之间的关联。对治疗前形态学和血流动力学状况的分析将有助于检测出WEB会发生更明显改变的动脉瘤病例。
