Virtual simulation with Sim&Size software for Pipeline Flex Embolization: evaluation of the technical and clinical...

Area of Science:

• Neurosurgery
• Medical Imaging
• Interventional Radiology

Background:

• Accurate stent selection (length, diameter, location) is crucial for successful flow diversion in aneurysm treatment.
• Sim&Size software utilizes 3D rotational angiography (3D-RA) to simulate stent deployment, aiding in optimal sizing and assessing wall apposition.

Purpose of the Study:

• To evaluate the technical and clinical impact of using Sim&Size software during Pipeline Flex Embolization Device treatment for aneurysms.

Main Methods:

• A retrospective analysis of consecutive patients undergoing Pipeline embolization for aneurysms between January 2015 and December 2017.
• Patients were divided into two groups: those treated with and without Sim&Size simulation.
• Univariate and multivariate models assessed the rates of corrective intervention, intervention duration, radiation dose, and stent length.

Main Results:

• Procedures with Sim&Size simulation showed a significantly lower rate of corrective intervention (9% vs. 20%, p=0.036).
• Simulation use was associated with shorter intervention duration (46 min vs. 52 min, p=0.002) and lower median radiation dose (1150 mGy vs. 1558 mGy, p<0.001).
• The software-assisted group also used shorter stents on average (14 mm vs. 16 mm, p<0.001).

Conclusions:

• Virtual simulation with Sim&Size software significantly reduces the need for corrective interventions in Pipeline treatments.
• The use of this simulation technology leads to decreased procedural time and radiation exposure.
• Sim&Size aids in selecting optimal stent length, contributing to improved treatment efficiency and outcomes.