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Simulator Training for Endovascular Neurosurgery
Published on: May 6, 2020
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Simulation of superselective catheterization for cerebrovascular lesions using a virtual injection software
Sri Hari Sundararajan1, Srirajkumar Ranganathan2, Vaishnavi Kishore3
1Department of Neurosurgery, Division of Interventional Neuroradiology, New York Presbyterian Hospital/Weill Cornell Medical Center, 525 East 68th St, New York, NY, 10065, USA. sns9009@med.cornell.edu.
CVIR Endovascular
|June 14, 2021
Summary
Virtual injection software using cone-beam CTs (CBCTs) accurately guided cerebrovascular lesion embolization planning. Neurointerventionalists found the tool clinically useful for procedures like arteriovenous malformation embolization.
Area of Science:
- Medical Imaging
- Interventional Neuroradiology
- Surgical Planning Software
Background:
- Cone-beam CT (CBCT) is increasingly used for embolization of cerebrovascular lesions.
- Virtual injection software offers potential for enhanced procedural planning.
- Feasibility of CBCT-based virtual injection software for cerebrovascular embolization requires evaluation.
Purpose of the Study:
- To assess the feasibility and accuracy of virtual injection software based on CBCT for planning cerebrovascular lesion embolization.
- To evaluate the clinical utility of this software in guiding neurointerventional procedures.
Main Methods:
- Retrospective review of 9 cerebrovascular lesion embolization cases (arteriovenous malformations, dural arteriovenous fistula, mycotic aneurysm) using CBCTs (2013-2020).
- Two neurointerventionalists utilized dedicated virtual injection software (EmboASSIST) to identify Points of Interest (POIs) and analyze vascular traces.
- Accuracy of vascular traces was assessed using 2D multiplanar reconstructions; clinical utility was rated on a 3-point Likert scale.
Main Results:
- A total of 26 POIs were identified across various arterial segments.
- Reviewers deemed all 26 POI traces, encompassing 90 vascular segments, as accurate.
- Average clinical utility scores were high (2.7 and 2.8), indicating significant perceived benefit for procedural planning.
Conclusions:
- CBCT-based virtual injection software is considered clinically useful and accurate for guiding and planning cerebrovascular lesion embolization.
- Further prospective studies in larger patient cohorts are recommended to validate this imaging modality.
