Abstract TP74: A Novel Virtual Stent Software for the Stent Assisted Coil Embolization of Brain Aneurysm
[Introduction] In stent-assisted coil embolization for brain aneurysms, precise deployment of the delivered stent is essential to achieve optimal angiographical outcome. However, it is frequently difficult to predict where the proximal end of the delivered stent lands due to complicated 3D structure of the target artery. A new software “Virtual Stent (VS) (Siemens AG, Forchheim, Germany)”, is designed to simulates the location of proximal and distal ends of the delivered-stent based on the 3D angiogram, thereby the program help an interventionalist to choose the best suitable profile of the stent before delivery. To evaluate the accuracy of the program, retrospective analysis of the previously treated patients using VS was performed.
[Methods] We retrospectively applied VS to post-treatment 3D DSA images in 44 aneurysm patients who were treated with stent-assisted coiling using Enterprise Stent®. Distal marker of VS was aligned to that of EP, and discrepancy between the proximal marker of VS and EP was measured. The mean/maximal discrepancy was calculated in three groups with different length of EP, and evaluation was performed.
[Results] In all cases, VS was successfully applied on each 3D DSA image. Overall avarage discrepancy between the proximal marker of VS and that of EP was 1.20mm. The mean/maximum discrepancy varied among the 3 groups with different EP length, 22mm (8 cases): 2.29mm/3.7mm, 28mm (32 cases): 0.93mm/2.5mm, 37mm (4 cases): 1.21mm/1.8mm. In the anterior circulation cases, the mean/maximum discrepancy were 1.33mm/3.7mm respectively, while in the posterior circulation the discrepancy was 0.91mm/2.34mm. In every case, it was considered that the discrepancy between the EP and VS was minimal and the VS could be a good predictor of the final positioning of a delivered EP.
[Conclusion] For stent assisted coil embolization of the brain aneurysms, VS simulation provides acceptable accuracy for planning the stent size and its positioning.
- © 2012 by American Heart Association, Inc.