Three-dimensional quantitative analysis of WEB shape modification: morphological and positional evaluation of the device at post-treatment and follow-up

MUÑOZ ROMINA; JANOT KEVIN; DAZEO NICOLÁS; BANKOLE NOUROU DINE; NARATA ANA PAULA; ROUCHAUD AYMERIC; LARRABIDE IGNACIO

Val d'Isère

Conferencia; ABC WIN; 2024

Motivation WEB shape modification has been analysed in relation to the anatomical result of the treatment and techniques have been presented to obtain one-dimensional measurements of the device. In this work we present more precise and 3D measurements of the WEB and the analysis of its differences between post-treatment and follow-up. Materials and method 3D surface models of the WEB at post-treatment and at follow-up were obtained by segmentation of XA 3DCT images of seventeen patients treated with WEBs. Three- dimensional measurements of height, maximum diameter, volume and surface area were calculated from these surfaces and the change between acquisitions of each variable was statistically evaluated (Wilcoxon signed-rank paired test, p-value 0.05). We also calculated, for both acquisitions, two positional variables, the angle of the WEB axis with respect to the parent artery, and the distance between the WEB center of mass and the artery bifurcation. The change of these positional variables was also statistically analysed. The cases were classified according to the aneurysm rupture status (Unruptured/Ruptured) and aneurysm occlusion degree (Adequate Occlusion/Aneurysm Remnant) and the differences between post-treatment and follow-up were analysed in each group. Results We observed a height decrease in fifteen cases with a mean change of -33.77% (28.4) while the maximum diameter increased in fifteen cases with a mean modification of 7.51% (6.47). Ten cases (58.82%) presented a volume decrease with a decrease mean of -15.6% (7.49) and a surface area mean increase of 7% (5.09) was observed in eleven cases (88.23%). The positional variables also showed changes after treatment, the distance between WEB center of mass and artery bifurcation increase in 10 cases (58.82%) with a mean increase of 10.08% (6.71). In 16 cases (94.12%) the angle between WEB axis and parent artery changed with a mean variation of 39.45% (32.1).Conclusions Three dimensional quantification of morphology and position of the WEB at post-treatment and follow-up allows us to obtain a more complete and comprehensive assessment of the changes suffered by the device between acquisitions.