gms | German Medical Science

67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12. - 15. Juni 2016, Frankfurt am Main

Artikel

Artikel empfehlen

Advantages of virtual clip preselection in aneurysm-surgery

Meeting Abstract

Suche in Medline nach

  • Eike Schwandt - Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Mainz, Germany
  • Ralf Kockro - Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Mainz, Germany; Neurochirurgie Hirslanden, Klinik Hirslanden, Zürich, Switzerland
  • Andreas Kramer - Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Mainz, Germany
  • Ali Ayyad - Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Mainz, Germany
  • Martin Glaser - Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Mainz, Germany
  • Alf Giese - Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Mainz, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocP 003

doi: 10.3205/16dgnc378, urn:nbn:de:0183-16dgnc3788

Veröffentlicht: 8. Juni 2016

© 2016 Schwandt et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

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.