Simplified volume embolization ratio calculation method in endovascular coiling for unruptured cerebral aneurysms

Area of Science:

• Neurosurgery
• Interventional Radiology
• Medical Device Technology

Background:

• Volume embolization ratio (VER) is crucial for predicting recurrence in cerebral aneurysm coiling.
• Current methods lack intraoperative clarity for VER assessment.
• Accurate intraoperative VER is needed to optimize treatment outcomes.

Purpose of the Study:

• To introduce and evaluate a simplified, real-time method for calculating aneurysm VER during endovascular coiling.
• To compare the simplified VER calculation with a standard software application.
• To assess the clinical applicability and accuracy of the simplified method.

Main Methods:

• A simplified formula D = 2V was used to calculate aneurysm volume (sV) and VER (sVER).
• Comparison of sVER with software-calculated VER (aVER) and simplified Angiosuite VER (saVER).
• Postoperative follow-up using MRA/DSA at 3, 6, and 12 months to evaluate Raymond Roy occlusion classification (RROC).

Main Results:

• No significant statistical difference was found between simplified VER (sVER) and software-based VER (aVER) (P=0.06).
• No significant statistical difference was found between sVER and simplified Angiosuite VER (saVER) (P=0.9).
• Eight of 18 patients showed improved RROC at 12 months, with no worsening observed.

Conclusions:

• The simplified VER calculation method is accurate and provides a clinically acceptable approximation.
• This method can be performed in real-time during surgery, enhancing procedural assessment.
• It offers a practical alternative without requiring additional software or devices.