P.034 Evaluation of modeling software for deployment of Pipeline stents in the endovascular treatment of intracranial aneurysms

Abstract

Background: Flow diversion is an established endovascular method for the treatment of intracranial aneurysms. The Pipeline Embolization Device (PED) remains the only FDA-approved stent available in USA and Canada since 2011. Stent position plays an important role in determining long-term success. The Leonardo Workstation(Siemens) is used for planning the ideal stent size and post-deployment destination. This first-ever study evaluates the accuracy of modeling software in predicting PED location post-deployment. Methods: 48 PED-assisted cases were performed 2012-2018 at the University of Alberta Hospital. 20 fit our preliminary inclusion criteria (single stents, simple anatomy). The proximal and distal landing zones were used to model the ideal stent using Leonardo. Accuracy was measured by comparing the Leonardo-predicted stent length vs known length. Results modeling against the dimensions predicted by AngioSuite, an app-based interface designed for use in the planning stages. Results: Leonardo workstation is accurate within 5mm at predicting final length for stents oversized by ≥0.25 cm. The predicted difference by Leonardo workstation & AngioSuite did not demonstrate statistical significance (P=0.36, P=0.24 respectively). Conclusions: Current angiographic planning tools are accurate at predicting PED deployment within 5mm. Complex vascular anatomy and deployment of multiple stents make prediction challenging. Analysis of these complex cases is currently underway.