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Utility of virtual stenting in treatment of cerebral aneurysms by flow diverter devices

  • Neuroradiology
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Abstract

Successful endovascular treatment by stenting of intracranial aneurysms requires proper placement of the device and appropriate choice of its diameter and length. To date, several methods have been employed to achieve these goals, although each has inherent critical issues. Recently developed stent planning software applications can be used to assist interventional neuroradiologists. Based on a 3D-DSA image acquired before stenting, these applications simulate and visualize the final placement of the deployed stent. In this single-centre retrospective study, 27 patients undergoing an intravascular procedure for the treatment of intracranial aneurysms from June 2019 to July 2020 were evaluated according to strict inclusion criteria. Stent virtualization was performed with Syngo 3D Aneurysm Guidance Neuro software. We compared the software-generated stent measurement and measurements taken by the interventional radiologist. Statistical analysis was performed using the STAC web platform. Mean and standard deviations of absolute and relative discrepancies between predicted and implanted stents were recorded. Friedman's nonparametric test was used to refute the null hypotheses, i.e. (I) discrepancies between the size of virtual and implanted stents would occur, and (II) operator influence does not affect the outcome of the virtual stenting process. Based on these observations, it is believed that the virtual stenting process can validly assist interventional neuroradiologists in selecting the appropriate device and reducing peri- and post-procedural complications. The results of our study suggest that virtual reality simulation of devices used for endovascular treatment of intracranial aneurysms is a useful, rapid, and accurate tool for interventional procedure planning.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Interventional Neuroradiology. Department of Advanced Biomedical Sciences, University “Federico II”, Via Pansini, 5, 80131, Naples, Italy

    Francesco Briganti, Mario Tortora, Giovanni Loiudice, Margherita Tarantino, Amedeo Guida, Giuseppe Buono, Mariano Marseglia & Fabio Tortora

  2. Department of Precision Medicine, University of Campania L. Vanvitelli, Naples, NA), Italy

    Ferdinando Caranci

Authors
  1. Francesco Briganti
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  2. Mario Tortora
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  3. Giovanni Loiudice
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  4. Margherita Tarantino
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  5. Amedeo Guida
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  6. Giuseppe Buono
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  8. Ferdinando Caranci
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  9. Fabio Tortora
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by FB, MT and FT. The first draft of the manuscript was written by FB and MT, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Mario Tortora.

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The authors have no relevant financial or non-financial interests to disclose.

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This is an observational study. Our Institutional Research Ethics Committee has confirmed that no ethical approval is required.

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Informed consent was obtained from all individual participants included in the study.

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Briganti, F., Tortora, M., Loiudice, G. et al. Utility of virtual stenting in treatment of cerebral aneurysms by flow diverter devices. Radiol med 128, 480–491 (2023). https://doi.org/10.1007/s11547-023-01620-x

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  • DOI: https://doi.org/10.1007/s11547-023-01620-x

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