Clinical impact of Sim & Size^® simulation software in the treatment of patients with cerebral aneurysms with flow-diverter Pipeline stents

Abstract

Objectives This study evaluated the clinical impact of the Sim&Size® simulation software on the endovascular treatment with flow-diverter stents of patients with unruptured saccular intracranial aneurysms. Methods This monocentric retrospective study evaluated a cohort of patients treated with flow-divert stents between June 1, 2014, and December 31, 2019, for cerebral aneurysms. Patients belonged to two groups, patients treated with and without the Sim&Size® simulation software. Univariate, bivariate, and multivariate analyses were used to evaluate the clinical impact of simulation software. Results Out of the 73 interventions involving 68 patients analyzed by the study, 76.7% were simulated using the Sim&Size® simulation software, and 23.3% were not. Patients treated with the simulation software had shorter stent lengths (16.00 mm vs. 20.00 mm p-value = 0.001) and surgical time (100.00 min vs. 118.00 min p-value = 0.496). Also, fewer of them required more than one stent (3.6% vs. 17.6% p-value = 0.079). Three patients belonging to the non-stimulated group presented hemorrhagic complications. Conclusions Using the Sim&Size® simulation software for the endovascular treatment of intracranial aneurysms with pipeline flow-diverter stents reduces the stent length.

Effects of different stent size selection on pipeline embolization device treatment of intracranial aneurysms

“…To facilitate stent selection and improve the intervention process, an increasing number of virtual stent software programs have been developed, 13 , 14 , 20 and several studies have found that using these software may decrease the stent size or number. 16 , 17 The association between PED size and patient outcome remains unclear, however.…”

“…In addition, as previously reported, a longer PED may also increase the risk of arterial side branch and perforator occlusion. 13 , 15 , 17 , 20 From this aspect, virtual stent software 16 , 17 should be encouraged given that they may provide distinct advantages in PED length selection and deployment. According to the results of this study, it is recommended that the DL could be as small as possible yet at least greater than 0 mm (this means that the length of the stent is usually larger than the neck of the aneurysm and covers the proximal and distal ends of the aneurysm by at least 5 mm).…”

“…Interestingly, some studies have found that the application of these software can reduce the stent size. 16 , 17 The true impact of this change on outcomes remains unknown, however. Therefore, we conducted this retrospective study to investigate the potential effects of different PED size selections on the clinical and angiographic outcomes of aneurysm treatments.…”

Intracranial aneurysms treatment using new generation FRED X flow diverters with antithrombotic coating and preoperative PreSize Neurovascular software simulation: literature review and own clinical observations analysis

“…29, N3, 2023 покриттям [7,8] і доопераційне моделювання на підставі 3D-RA-протоколу ангіографії. Доопераційне моделювання дає змогу обрати найоптимальніший за розміром ФД та його оптимальну позицію в артерії [9].…”