Smarter Planning, Greater Support: What’s New in Sim&Size
1. Why this evolution matters
At Sim&Cure, we believe technology should adapt to the way clinicians work – not the other way around – to better support their neurovascular planning and decision-making.
Through years of close collaboration with medical teams worldwide, our engineers have continuously refined Sim&Size: a process of listening, testing, and iterating that reflects the time, expertise, and dedication required to bring a medical device to life.
The result is a set of enhancements focused not just on adding functionalities, but on optimizing workflow, providing deeper insights on advanced device-specific metrics, and expanding treatment options.
Let us introduce several new capabilities that strengthen Sim&Size’s ability to support real-life procedures, from workflow automatization and new advanced device-specific metrics to an expanded device portfolio and hospital-refined integration.
Plan easily with Hyperspace Mode
From patient selection to simulation in just one step, the software automatically processes the region of interest, microcatheter inlet, dome, and neck: streamlining your workflow so you can focus on the treatment strategy.
Every step remains reviewable and adjustable, giving you speed without compromise.
Pre-planning from MRA images*
Start planning cases at the very beginning of the patient pathway. With new TOF-MRA compatibility, you can begin discussing strategies earlier, prepare for complex anatomies, and save time before angiography.
Run full simulations directly from TOF-MRA images to preliminary evaluate treatment strategy and discuss with the care team from the start. Enhance communication across specialties and streamline planning in the patient care workflow, before angiography.
Because planning can be early in the patient pathway, Sim&Size add valuable insights to training sessions, interdisciplinary discussions, and even patient communication.
Simulation overlay in the angiosuite
With new imaging system, push the simulated device to the Cathlab and overlay it with live angiography. This feature facilitates continuity between pre-procedural planning and intra-procedural visualization.
New advanced device-specific metrics: more than visualization
Sim&Size introduces a new generation of quantitative metrics designed to enhance the understanding of device–anatomy interaction.
Among these, relative sizing provides a segment-by-segment analysis of how the simulated device conforms to the reconstructed parent artery, quantifying the relationship between the device diameter and vessel geometry across the landing zone and providing insight into how well the chosen device sizing aligns with local vessel variations.
Complementary metrics, including the Local Pore Density for Flow diverters, the Device–Aneurysm Volume (DAV) Ratio, and the Spruce Index for Intrasaccular devices, offer further insights into device deployment and intra-aneurysmal behavior.
Together, these parameters support a more detailed and objective evaluation of treatment strategies, contributing to the continuous exploration of how simulation can be a strong ally for decision-making.
3. How it helps you – and fits into your practice
From planning complex procedures like Y-stenting, evaluating how flow diverter diameter compares to the artery segment by segment, or optimizing intrasaccular device sizing, Sim&Size now provides even greater device-specific insight.
For example, in a case involving a wide-neck aneurysm, a clinician can:
- Pre-plan the procedure from TOF-MRA images
- Simulate a stent assisted coiling procedure including Y-stenting with the 3DRA image of the day of the intervention
- Evaluate simultaneously the Spruce Index and compression metrics through the simulation for optimized intrasaccular device sizing
- Add the simulated device to the live 3D roadmap to visualize the deployment you aim to achieve
Our goal remains the same: to support confident decisions and enhance treatment planning — all backed by clinically validated simulation results*
4. Your next step
If you’re already using Sim&Size, these enhancements will be available for you shortly. If you’re not yet a user, now is a great time to discover what simulation can bring to your practice.
💬 From Mathieu Sanchez
“Sim&Size continues to evolve alongside the clinicians who use it every day. Every improvement we make is rooted in feedback from the field, so our technology truly fits clinical reality.”
Want to see it in action?
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The currently marketed version of Sim&SizeTM enables visualization of the patient’s cerebral blood vessels and the computationally modeled placement and apposition of neurovascular implantable medical devices for preoperative planning of neurovascular interventions, information provided by the software is not intended in any way to eliminate, replace, or substitute for, in whole or in part, the healthcare provider’s judgment and analysis of the patient’s condition. Read the instructions for use carefully before use.
The use of Sim&Size™ is contraindicated in the following cases:
• in the event of giant intracranial aneurysms involving poor reconstruction of the deployment zone.
• in the presence of artifacts in the planned implantable medical device deployment zone.
• when there is a possible contact of an implanted device with the simulated implantable medical device in the deployment zone.
Sim&Size complies with the relevant applicable regulations. It should be noted that market authorization can differ depending on your location, so please contact us for more information.
*References:
- Piergallini, Lorenzo et al. “Virtual simulation with Sim&Size software for Pipeline Flex Embolization: evaluation of the technical and clinical impact.” Journal of neurointerventional surgery vol. 12,10 (2020): 968-973. doi:10.1136/neurintsurg-2020-015813
- Cagnazzo, Federico et al. “Comparison of Woven EndoBridge device sizing with conventional measurements and virtual simulation using the Sim&Size software: a multicenter experience.” Journal of neurointerventional surgery vol. 13,10 (2021): 924-929. doi:10.1136/neurintsurg-2020-017060
- Cagnazzo, Federico et al. “Woven EndoBridge device apposition and compression using Sim&Size virtual simulation correlate with aneurysm occlusion status: a retrospective cohort study.” Journal of neurointerventional surgery, jnis-2024-022135. 13 Nov. 2024, doi:10.1136/jnis-2024-022135
- Di Salle G, et al. Interdependence of First-coil and Global volume embolization ratios (VERs) calculated by Sim&Size in predicting aneurysm occlusion outcomes. Interv Neuroradiol. 2025 May 21:15910199251341652. doi: 10.1177/15910199251341652. Epub ahead of print. PMID: 40398469; PMCID: PMC12095266.