Introduction Safe and complete treatment of intracranial aneurysm requires a thorough understanding of the complex three-dimensional vascular structure specific to each patient. We introduced a 3D vascular model mixed reality (MR) in endovascular treatment to enhance anatomical confidence.

Aim of Study This study aims to validate the usefulness and feasibility of a MR application in the endovascular treatment of intracranial aneurysms.

Methods Developed an application software called Object Loader using the Unity program, enabling the upload and manipulation of a 3-D vascular model on the Hololens. From September 2021, endovascular procedures were performed on consecutive patients with intracranial aneurysms, utilizing MR assistance. A score system composed of total score 7 was employed to evaluate the merits of MR application in each case.

Results Between September 2021 and March 2023, 54 MR-assisted endovascular treatments were performed on 51 patients. No immediate complications were observed. Favorable occlusion was achieved in 80% of cases. Discrimination of overlapped vasculature and rechecking dangerous regions were the most useful merits.

Conclusion In conclusion, the utilization of mixed reality with a 3-dimensional vascular model digital twin enhanced the anatomical confidence and safety of endovascular procedures for the treatment of intracranial aneurysms. The discrimination of overlapped vascular structures and real-time alarming of the physician regarding dangerous areas during the procedure demonstrated the usefulness of this technology. The continuous evolution of augmented reality has the potential to revolutionize daily procedures.

Disclosure of Interest nothing to disclose