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E-078 Postprocessing to aid simulation planning of stent assisted coil embolization and flow diversion procedure using virtual stenting
  1. K Raghuram,
  2. A Saleem
  1. Radiology, UTMB, Galveston, TX.

Abstract

Purpose Use post processing techniques to assess the diameter as well as length of stent needed as an adjunct to aneurysm coil embolization.

Materials and methods Intracranial 3D Digital subtraction angiographic images obtained on a Siemens Artis Zee angiography suite were reviewed on 10 patients with intracranial aneurysms. Post processing was performed on a dedicated Leonardo workstation. Vessel segmentation was performed. After applying thresholding, intraluminal navigation was performed using the platform to assess the geometry of the aneurysm neck. Diameter of the vessel as well as potential stent length were measured by an automatic stent planning algorithm available which allowed virtual stenting. Planning and postprocedure images were compared to assess accuracy of stent sizing and positioning.

Results Vessel diameter as well as stent length were used for planning stent assisted coiling or flow diverter embolization of the aneurysm. The planning tool proved very helpful with measuring vessel diameters accurately and for deciding on stent length, specifically with flow diverters. The virtual stenting algorithm allowed for better planning of the proximal and distal landing zones of the devices. Final post stent placement results compared favorably with the proposed virtual stent positioning.

Conclusion Detailed post processing provides another tool to allow better planning for endovascular embolization procedures requiring stent or flow diverter placement. Virtual stenting allows for more accurate and detailed assessment of length and delivery zone of the stent.

References

  1. . Xiang J, Damiano RJ, et al. High-fidelity virtual stenting: modeling of flow diverter deployment for hemodynamic characterization of complex intracranial aneurysms.J Neurosurg. 2015Oct;123(4):832–40. doi: 10.3171/2014.11.JNS14497. Epub 2015 Jun 19.

  2. . Egger J1, Grosskopf S, et al. Modeling and visualization techniques for virtual stenting of aneurysms and stenoses. Comput Med Imaging Graph. 2012 Apr;36(3):183–203. doi: 10.1016/j.compmedimag.2011.12.002. Epub 2012 Jan 9.

Disclosures: K. Raghuram: None. A. Saleem: None.

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