The impact of pre-treatment aneurysm angulation. What happens with WEB devices at follow-up?

Romina Muñoz ¹, Nicolás Dazeo ², Camila García ¹

⁰Instituto PLADEMA - CONICET, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina.

Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences +

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January 28, 2025

View abstract on PubMed

Summary

WEB shape modification is linked to aneurysm occlusion outcomes. Pre-treatment vascular conditions predict significant WEB device changes, aiding treatment selection for better results.

Area Of Science

Neuroendovascular surgery
Medical device engineering
Biomedical imaging

Background

WEB device shape modification impacts aneurysm occlusion.
Previous studies used 1D measurements to quantify WEB changes post-implantation.
This study analyzes 3D morphology and hemodynamics of WEB-treated aneurysms.

Purpose Of The Study

To analyze pre-treatment vascular morphology and hemodynamics in WEB-treated aneurysms.
To detect modifications in WEB device morphology and position using 3D quantification.
To understand the influence of pre-treatment conditions on WEB shape changes.

Main Methods

Included 17 WEB-treated aneurysms with pre-treatment, post-treatment, and follow-up 3D CT scans.
Performed 3D measurements of WEB morphology and position at post-treatment and follow-up.
Utilized CFD simulations and statistical analysis (Wilcoxon signed-rank, Mann-Whitney U) to evaluate WEB changes and pre-treatment factors.

Main Results

WEB height and diameter showed statistically significant changes.
Aneurysm angle modification was significantly higher in the WEB shape modification group.
Higher inflow ratio and smaller pre-treatment aneurysm angles were observed in the shape modification group.

Conclusions

Found an association between WEB morphological changes and its axis orientation within the aneurysm.
Pre-treatment morphological and hemodynamic analysis can identify aneurysms likely to undergo significant WEB modification.
Predicting WEB changes aids in selecting appropriate cases for treatment.

Keywords:

3D WEB quantification WEB shape modification pre-treatment CFD simulations pre-treatment aneurysm angle