Neurological Surgery 脳神経外科52巻2号

2024年03月発行

特集 ITを駆使した術前シミュレーション—トラブル回避と時短手術習得 Ⅰ 術前シミュレーションの概要

血管内治療のためのシミュレーション

著者： 加藤直樹¹ 藤村宗一郎²³ 佐野透¹ 榎本弘幸¹ 府賀道康¹ 長山剛太¹ 畑岡峻介¹ 菅一成¹ 石橋敏寛¹ 村山雄一¹

所属機関： ¹東京慈恵会医科大学脳神経外科 ²東京理科大学工学部機械工学科 ³東京慈恵会医科大学総合医科学研究センター先端医療情報技術研究部

ページ範囲：P.263 - P.269

Point
・展開後の伸長・短縮を加味したステント留置のシミュレーションができるようになってきている．
・3Dプリンターモデルを使用して，コイル塞栓術アシスト用ステントやフローダイバーター，Woven EndoBridge（WEB）の留置，シャント疾患治療の事前シミュレーションが可能である．
・医工連携とシミュレーションに対する薬事承認や保険収載，そのための適切な事業化が今後の重要課題である．

参考文献

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2）Fujimura S, et al：Hemodynamics and coil distribution with changing coil stiffness and length in intracranial aneurysms. J Neurointerv Surg 10：797-801, 2018

3）Fujimura S, et al：Effect of catheter positions on hemodynamics and coil formation after coil embolization. Annu Int Conf IEEE Eng Med Biol Soc 2017：3397-3400, 2017

4）Nishimura K, et al：Accuracy of length of virtual stents in treatment of intracranial wide-necked aneurysms. Cardiovasc Intervent Radiol 42：1168-1174, 2019

5）Watanabe N, et al：Utility of multi-material three-dimensional print model in preoperative simulation for glioma surgery. J Clin Neurosci 93：200-205, 2021

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8）Kan I, et al：A novel braided stent with customized simulation software for treatment of intracranial aneurysms：multicenter prospective trial before unrestricted clinical application. Oper Neurosurg（Hagerstown） 26：180-187, 2024

9）Du Z, et al：AngioSuite-assisted volume calculation and coil use prediction in the endovascular treatment of tiny volume intracranial aneurysms. Biomed Res Int 2021：5514608, 2021　doi:10.1155/2021/5514608

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15）Fujimura S, et al：Computational fluid dynamic analysis of the initiation of cerebral aneurysms. J Neurosurg 137：335-343, 2021

16）Suzuki T, et al：Multivariate analysis for predicting internal carotid（IC）and middle cerebral（MC）aneurysmal rupture by hemodynamic parameters. Annu Int Conf IEEE Eng Med Biol Soc 2018：1339-1342, 2018

17）Murayama Y, et al：Computational fluid dynamics as a risk assessment tool for aneurysm rupture. Neurosurg Focus 47：E12, 2019　doi:10.3171/2019.4.FOCUS19189

18）Fujimura S, et al：A new combined parameter predicts re-treatment for coil-embolized aneurysms：a computational fluid dynamics multivariable analysis study. J Neurointerv Surg 10：791-796, 2018

19）Ishii T, et al：Hemodynamic and morphologic factors related to coil compaction in basilar artery tip aneurysms. World Neurosurg 155：e95-e110, 2021　doi:10.1016/j.wneu.2021.08.011

20）Watanabe N, et al：Real stiffness and vividness reproduction of anatomic structures into the 3-dimensional printed models contributes to improved simulation and training in skull base surgery. Oper Neurosurg（Hagerstown）24：548-555, 2023

21）久村和香，他：医工連携・イノベーション・IT活用を視野に入れた脳神経外科学講座が取り組む学生教育指導の概要と医学生視点からの評価．慈恵医大誌138：33-39, 2023