The impact of pre-treatment aneurysm angulation. What happens with WEB devices at follow-up?

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Interventional Neuroradiology Pub Date : 2025-01-28 DOI:10.1177/15910199251316411

Romina Muñoz, Nicolás Dazeo, Camila García, Kevin Janot, Nourou Dine Adeniran Bankole, Ana Paula Narata, Aymeric Rouchaud, Ignacio Larrabide

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引用次数: 0

Abstract

Background: WEB shape modification has been analyzed in relation to the aneurysm occlusion outcome and techniques have been presented with one-dimensional measurements of the device to quantify the change after implantation. In this work, we present an analysis of pre-treatment vascular morphology and hemodynamics of cases treated with WEB devices, which were three-dimensionally quantified in morphology and position to detect modifications.

Methods: Seventeen WEB-treated aneurysms with pre-treatment, post-treatment and follow-up 3D flat-panel CT were included. Three-dimensional measurements of the WEB morphology and position were made at post-treatment and at follow-up. Differences between acquisitions of all measured variables were statistically evaluated (Wilcoxon signed-rank paired test, P-value = 0.05). Pre-treatment aneurysm angles were three-dimensionally measured and CFD simulations were performed to evaluate the influence of flow on WEB changes.

Results: WEB height and diameter presented statistically significant changes. Modification of the angle between the WEB axis and parent artery was significantly higher in the group with WEB shape modification (Mann-Whitney U test, P < 0.05). In this group, the median pre-treatment aneurysm angle was smaller than in the group without shape modification (8.16° vs. 13.14°, P = 0.06). Inflow ratio was higher in the WEB shape modification group.

Conclusions: An association between the magnitude of morphological changes of the WEB with the direction of its axis within the aneurysm was found. The analysis of pre-treatment morphological and hemodynamic conditions would allow the detection of aneurysm cases in which the WEB will undergo a more pronounced modification.

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治疗前动脉瘤成角的影响。WEB设备在随访时会发生什么？

背景：已经分析了形状改变与动脉瘤闭塞结果的关系，并提出了通过设备的一维测量来量化植入后的变化的技术。在这项工作中，我们对使用WEB装置治疗的病例的治疗前血管形态和血流动力学进行了分析，这些设备在形态和位置上进行了三维量化以检测改变。方法：采用三维平板CT对17例经web治疗的动脉瘤进行治疗前、治疗后及随访。在治疗后和随访时对WEB的形态和位置进行三维测量。对所有测量变量的获取差异进行统计学评价（Wilcoxon sign -rank配对检验，p值= 0.05）。三维测量治疗前动脉瘤角度，并进行CFD模拟以评估流量对WEB变化的影响。结果：WEB高度和直径变化有统计学意义。WEB形状改变组WEB轴与母动脉夹角改变明显高于WEB形状改变组（Mann-Whitney U检验，P P = 0.06）。WEB形状修饰组的入流率较高。结论：发现WEB形态变化的大小与其在动脉瘤内轴向有关。治疗前形态学和血流动力学条件的分析将允许检测动脉瘤病例，其中WEB将经历更明显的改变。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Interventional Neuroradiology CLINICAL NEUROLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

3.60

自引率

11.80%

发文量

192

审稿时长

6-12 weeks

期刊介绍： Interventional Neuroradiology (INR) is a peer-reviewed clinical practice journal documenting the current state of interventional neuroradiology worldwide. INR publishes original clinical observations, descriptions of new techniques or procedures, case reports, and articles on the ethical and social aspects of related health care. Original research published in INR is related to the practice of interventional neuroradiology...