P080 Numerical simulation of individual coil placement – A proof–of–concept study for the prediction of recurrence after aneurysm coiling

<h3>Introduction</h3> Coiling is the most used method for interventional aneurysm occlusion. The choice of the specific coil has an important influence on secondary regrowth, requiring retreatment, and is made based on expert opinions. Individual simulations of the coiling procedure could provide additional information and save costs for rejected coils.. <h3>Aim of Study</h3> To simulate coiling in different aneurysm geometries and to compare simulation results with clinical recurrence. <h3>Methods</h3> In a proof-of-principle study, we simulated coiling in 6 anterior circulation cases treated with a single coil, out of which 50% had a regrowth, defined as Raymond &amp; Roy class 2 or 3, observed in a follow–up angiography after 6 months using a newly developed numerical approach to simulate coil shapes. We then correlated simulation results with aneurysm recurrence. <h3>Results</h3> The simulation showed various coil shapes depending on the variability in possible microcatheter positions. Aneurysms with a later recurrence showed a tendency for more frequent successful coiling attempts. Further trends suggested lower simulated packing densities in aneurysms with reoccurrence. Simulated packing densities did not correlate with those calculated by conventional software, indicating the potential for our approach to offer additional predictive value. <h3>Conclusion</h3> Our study pioneers a comprehensive numerical model for the simulation of aneurysm coiling, providing insights into individualized treatment strategies and outcome prediction. This simulation framework holds promise for enhancing clinical decision-making and optimizing patient outcomes in endovascular aneurysm treatment after refinement in the future. <h3>Disclosure of Interest</h3> no.