Comparison of Woven EndoBridge device sizing with conventional measurements and virtual simulation using the Sim&Size software: a multicenter experience

医学 虚拟病人 尺寸 单变量分析 动脉瘤 核医学 多元分析 放射科 内科学 艺术 视觉艺术 医学教育
作者
Fédérico Cagnazzo,Gaultier Marnat,I. Coelho Ferreira,Pierre Daubé,Imad Derraz,Cyril Dargazanli,Pierre-Henri Lefevre,Grégory Gascou,Carlos Riquelme,Riccardo Morganti,Jérôme Berge,Florent Gariel,Xavier Barreau,Vincent Costalat
出处
期刊:Journal of NeuroInterventional Surgery [BMJ]
卷期号:13 (10): 924-929 被引量:13
标识
DOI:10.1136/neurintsurg-2020-017060
摘要

Background Selection of the appropriate device size mandatory during aneurysm treatment with a Woven EndoBridge (WEB). We aimed to investigate if virtual simulation with Sim&Size software may have an impact on technical, angiographic, and clinical outcomes after WEB treatment. Methods Data from two large-volume centers were collected and compared (January 2017–January 2020). Virtual simulation was systematically adopted in one center, while conventional sizing was used in the other one. Outcomes were the duration of intervention, the radiation dose (in milligrays, the number of corrective interventions for inappropriate WEB size, the number of WEBs not deployed, angiographic occlusion, and complications. Univariate and multivariate linear models were adopted. Results A total of 186 aneurysms were treated with WEB (109 with and 77 without virtual simulation). Patient characteristics and aneurysm features were comparable among virtual and conventional sizing, except for mean age (62.2±11.8 years and 56.2±10.1 years, P=0.0004) and median aspect ratio (1.6, IQR=1.2–2 and 1.2, IQR=1–1.6, P=0.0001). Years of operator experience were comparable. Virtual simulation was independently associated with shorter intervention time (45 min, IQR=33–63.5 min vs 63.5 min, IQR=41–84.7 min, P=0.0001), lower radiation dose (1051 mGy, IQR=815–1399 mGy vs 1207 mGy, IQR=898–2084 mGy, P=0.0001), and lower number of WEBs not deployed (26/77=33.7% vs 8/109=7.3%, P=0.0001). The need for additional maneuvers was significantly lower in the virtual simulation group (5/109=4.6% vs 12/77=15.6%, P=0.021). Angiographic outcomes and complications were comparable. Conclusions In this multicenter experience, virtual simulation with Sim&Size software seems to facilitate the selection of the appropriate WEB device for aneurysm treatment, reducing the time of intervention, the radiation dose, the number of devices not deployed, and the need for corrective interventions. Trial registration number clinicaltrials.gov Identifier: NCT04621552 .
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