A Multimodal Imaging Workflow for Intraprocedural Targeting of Endovascular Stentrode Deployment: Technical Feasibility in a Phantom Model

The Stentrode (Synchron) is a self-expanding nitinol stent brain-computer interface device deployed within the superior sagittal sinus adjacent to the precentral gyrus. Millimetric precision is required, underscoring the need for a reproducible imaging workflow translating preoperative planning into intraprocedural guidance. This non-clinical, preprocedural technical feasibility assessment used a human head model to simulate imaging steps. The workflow included thin-section CT acquisition; DICOM transfer to an external core lab for target identification and marking; re-importation of marked CT; 3D rotational angiography; and co-registration with marker reconstruction and intraprocedural display on live fluoroscopy. The CT provided a suitable dataset for anatomical analysis, and the core lab successfully marked the intended deployment region. Markers were preserved during transfer and re-importation. The annotated CT was successfully fused with 3DRA, without qualitatively apparent misalignment or artifact. This workflow was technically feasible for generating intraprocedural targeting guidance for Stentrode deployment.