EP38* Single center experience utilizing a novel augmented reality platform to teleproctor a neuroendovascular fellow

Abstract

Introduction Brain aneurysm treatment with the Woven Endo Bridge (WEB ® ) is widely accepted. For long term follow up a non-invasive imaging would be preferable to avoid potential risks from repetitive catheter angiography. Aim of the Study To evaluate which non-invasive imaging modality correlates best with DSA. Methods Four different realistic aneurysm models were designed and 3D printed and a WEB Device was implanted following the official sizing recommendations. Subsequently the devices were partially filled with silicone though a small borehole, intentionally leaving out a proportion of the devices volume. DSA images were made as reference, followed by MRI using T1-, T2-and TOF-sequences, as well as CT and Spectral CT scans. All Images were blinded and reviewed by two experienced readers using the WEB Occlusion Scale (WOS). Results In our model CT and Spectral CT Scans were all scored as WOS 0, resulting in 0% conformity with DSA. The readers agreed in 100% of the cases. Comparing MRI sequences with DSA consistent results were found in 9.4% of the cases. The readers scored concurring WOS in 68.8%. Conclusions From our analysis the detection of small residual inflows into aneurysms treated with WEB Devices, using noninvasive MRI or CT techniques is very unreliable and can not replace DSA for follow up. This is probably not true for recurrences outside the devices. Disclosure FW consults and proctors for Microvention. GK, MP and JM have no conflicts of interest.