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Predictive Accuracy and Procedural Benefits of Software-Enhanced Flow-Diverter Planning: A Systematic Review and
Dani Douri1, Paolo Panales2, Bailey Riehl2
1From the University of North Dakota School of Medicine & Health Sciences (D.D., P.P., B.R., S.W., C.W., S.G., B.S., M.R., Z.B.), Grand Forks, ND, USA; Department of Radiology (S.G., R.K., D.F.K.), and Department of Neurologic Surgery (S.G., A.R., R.K.), Mayo Clinic, Rochester, Minnesota, USA. dani.douri@und.edu.
AJNR. American Journal of Neuroradiology
|March 31, 2026
Summary
Software simulations aid in planning flow-diverting (FD) stent placement for intracranial aneurysms, showing accuracy comparable to physicians. This approach may improve procedural efficiency and outcomes.
Area of Science:
- Neurosurgery
- Medical Imaging
- Biomedical Engineering
Background:
- Flow-diverting (FD) stents are crucial for treating complex intracranial aneurysms.
- Precise pre-procedural planning is essential to minimize complications associated with FD stent deployment.
- Traditionally reliant on physician expertise, planning now incorporates advanced software simulations.
Purpose of the Study:
- To systematically review and compare physician-based planning versus software simulations for predicting FD stent deployment.
- To assess the clinical impact of integrating software into procedural metrics for aneurysm treatment.
Main Methods:
- A comprehensive systematic review and meta-analysis of studies comparing physician and software simulation for intracranial aneurysms.
- Searched major databases (PubMed, Embase, Web of Science, Scopus) through July 2025, adhering to PRISMA guidelines.
- Included 14 studies with comparative data on accuracy, agreement, and procedural metrics; analyzed using R and relevant statistical packages.
Main Results:
- Software simulations predicted shorter stent lengths than physicians but similar diameters.
- Software-chosen dimensions demonstrated accuracy post-implantation.
- Software-assisted procedures showed reduced duration, lower radiation dose, and fewer corrective interventions.
- No significant differences were observed in hemorrhagic complications or aneurysm occlusion rates.
Conclusions:
- Preliminary evidence supports the integration of virtual simulation software in pre-procedural planning for FD stent treatment.
- Further prospective, randomized studies are needed to definitively establish the clinical impact of simulation software.
- Software simulations offer a promising adjunct to physician expertise in optimizing intracranial aneurysm treatment planning.
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