Artikel
Advantages of virtual clip preselection in aneurysm-surgery
Suche in Medline nach
Autoren
Veröffentlicht: | 8. Juni 2016 |
---|
Gliederung
Text
Objective: To optimize surgical aneurysm occlusion we used a 3D-virtual-reality planning device (Dextroscope) to selected matching clips prior to the operation. To evaluate potential benefits we compared the postoperative results and the clinical outcome of elective aneurysm-surgery with preselected clip (n=19 aneurysms) and without (n=64 aneurysms).
Method: 0,5mm sliced CTA-scan or 1mm sliced MRI-scan of the neurocranium and an aneurysm clip (Fa Peter Lazic GmbH, Germany) database were uploaded into the dextroscope-3D-planning-station (Volume Interactions Ltd., Singapore). The dextroscope software allowed the surgeon to choose the most suitable clip for aneurysm size, shape and approach in virtual reality. Postoperatively the clipping-result was evaluated by angiography prospecting for remnants. Clinical outcome was rated using modified Rankin Scale (mRS).
Results: In procedures, in which the aneurysm was occluded with a preselected clip, complete closure was accomplished in 94,73% (n=19 aneurysms, 44,4% SAH), in the control-group in 87,5% (n=64 Aneurysms, 17,5% SAH). No mortality occurred in both groups. Good outcome (mRS ≤2 at 6 month) was achieved in the preselection group 100%, control-group 92,9%.
Conclusions: The preoperative selection and simulation of an optimal clip improved the the result of aneurysm surgery regarding the completeness of closure of the aneurysm and the postoperative morbidity-rate. Compared with ISUIA- (Wiebers 2003) and BRAT-study (Spetzler 2015) the occlusion rate and outcome are improved in this study.