Background: The purpose of this single-center retrospective review was to validate the use of a software-based simulation of Tubridge flow diverter (FD) in the treatment of intracranial aneurysms. In a single-center cohort of 17 patients undergoing aneurysm treatment with the Tubridge flow divert, we analyzed their pre- and post-procedural angiographic studies to compare the manufacturer-given nominal length (NL), software calculated simulated length (SL), and the actual measured length (ML) of the flow divert using software. Results: Data for the 3 lengths of all 17 patients treated with Tubridge flow diverts were collected and analyzed in this study. Error discrepancy was calculated by mean squared error (ML to NL 10.64; SL to NL 9.95 p>0.05), mean absolute error (ML to NL 2.64; SL to NL 2.60 p>0.05), and mean error (NL to ML 1.26; SL to ML 2.59 p>0.05). Conclusions: The SL was usually greater than the NL given by the manufacturer, indicating significant change in length in most cases. The residual comparing the ML to the NL was significant, as was when comparing the SL to the NL. The assessment of the Tubridge flow diverter using software simulation is safe and effective and the accurate calculating of FD length contributed to the right-sized FD for optimal placement in intracranial vasculature.
Background: Flow-Diverter (FD) porosity has been pointed as a critical factor in the occlusion of cerebral aneurysms after treatment.Objective: Verification and Validation of computational models in terms of predictive capacity, relating FD porosity and occlusion after cerebral aneurysms treatment.Methods: Sixty-four aneurysms, with pre-treatment and follow-up images, were considered. Patient demographics and aneurysm morphological information were collected. The computational simulation provided by ANKYRAS provided FD porosity, expansion, and mesh angle. FD occlusion was assessed and recorded from follow-up images. Multiple regression Logit and analysis of covariance (ANCOVA) models were used to model the data with both categorical and continuous models.Results: Occlusion of the aneurysm after 12 months was affected by aneurysm morphology but not by FD mesh morphology. A Time-To-Occlusion (TTO) of 6.92 months on average was observed with an SE of 0.24 months in the aneurysm population surveyed. TTO was estimated with statistical significance from the resulting model for the data examined and was capable of explaining 92% of the data variation.Conclusions: Porosity was found to have the most correction power when assessing TTO, proving its importance in the process of aneurysm occlusion. Still, further Verification and Validation (V&V) of treatment simulation in more extensive, multi-center, and randomized databases is required.
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