Identification of Parameters Influencing the Vascular Structure Displacement in Fusion Imaging during Endovascular Aneurysm Repair

Lalys, Florent; Barré, Alexandre; Kafi, Moundji; Benziane, Mohamed; Saudreau, Blandine; Dupont, Claire; Kaladji, Adrien

doi:10.1016/j.jvir.2019.02.022

Cited by 7 publications

(3 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In particular, Breininger et al [13] showed its accuracy by manually segmenting 2D images and fusing them with preoperative 3D CTA. Further work by Lalys et al [29] set out to quantify vascular displacement after stiff wire insertion via a pre-op 3D reconstruction and 2D intra-operative fluoroscopic imaging. Significant displacement was picked up by the fusion imaging, with a mean error of 4.1 ± 2.4 mm at the level of the renal arteries.…”

Section: Vascular Displacement After Stiff Wirementioning

confidence: 99%

A State-of-the-Art Review of Intra-Operative Imaging Modalities Used to Quality Assure Endovascular Aneurysm Repair

Bachrati

Torre

Chowdhury

et al. 2023

JCM

View full text Add to dashboard Cite

Endovascular aortic aneurysm repair (EVAR) is the preferred method for elective abdominal aortic aneurysm (AAA) repair. However, the success of this technique depends greatly on the technologies available. Intra-operative imaging is essential but can come with limitations. More complex interventions lead to longer operating times, fluoroscopy times, and greater contrast doses. A number of intra-operative imaging modalities to quality assure the success of EVAR have been developed. A systematic literature search was performed with separate searches conducted for each imaging modality in the study: computed tomography (CT), digital subtraction angiography (DSA), fusion, ultrasound, intra-operative positioning system (IOPS), and non-contrast imaging. CT was effective at detecting complications but commonly resulted in increased radiation and contrast dose. The effectiveness of DSA can be increased, and radiation exposure reduced, through the use of adjunctive technologies. We found that 2D-3D fusion was non-inferior to 3D-3D and led to reduced radiation and contrast dose. Non-contrast imaging occasionally led to higher doses of radiation. Ultrasound was particularly effective in the detection of type II endoleaks with reduced radiation and contrast use but was often operator dependent. Unfortunately, no papers made it past full text screening for IOPS. All of the imaging techniques discussed have advantages and disadvantages, and clinical context is relevant to guide imaging choice. Fusion and ultrasound in particular show promise for the future.

show abstract

Section: Vascular Displacement After Stiff Wirementioning

confidence: 99%

A State-of-the-Art Review of Intra-Operative Imaging Modalities Used to Quality Assure Endovascular Aneurysm Repair

Bachrati

Torre

Chowdhury

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…3D-3D registration was superior to 2D-3D registration regarding both the spread of values and the quality of agreement of several millimeters may be acceptable for utilization during endovascular therapy of peripheral arteries, complex endovascular procedures, such as fenestrated or branched endovascular aneurysm repair (EVAR), and visceral artery revascularization, carry a higher risk of potentially fatal complications. Lalys and colleagues suggested a clinically acceptable deviation of 3 mm for an EVAR procedure based on the mean size of the renal artery ostium of 6 mm (Lalys et al 2019), which has been adopted by other authors (Schulz et al 2016;Schulz et al 2019;Lalys et al 2019). Schulz and colleagues compared both fusion techniques on CT data sets in EVAR procedures on 50 patients using the craniocaudal deviation to the lower renal artery ostium.…”

Section: Table 1 Comparison Of Different Registration Techniques and Imaging Modalitiesmentioning

confidence: 99%

Accuracy of registration techniques and vascular imaging modalities in fusion imaging for aortic endovascular interventions: a phantom study

et al. 2021

View full text Add to dashboard Cite

Background This study aimed to assess the error of different registration techniques and imaging modalities for fusion imaging of the aorta in a standardized setting using a anthropomorphic body phantom. Materials and methods A phantom with the 3D printed vasculature of a patient suffering from an infrarenal aortic aneurysm was constructed. Pulsatile flow was generated via an external pump. CTA/MRA of the phantom was performed, and a virtual 3D vascular model was computed. Subsequently, fusion imaging was performed employing 3D-3D and 2D-3D registration techniques. Accuracy of the registration was evaluated from 7 right/left anterior oblique c-arm angulations using the agreement of centerlines and landmarks between the phantom vessels and the virtual 3D virtual vascular model. Differences between imaging modalities were assessed in a head-to-head comparison based on centerline deviation. Statistics included the comparison of means ± standard deviations, student’s t-test, Bland-Altman analysis, and intraclass correlation coefficient for intra- and inter-reader analysis. Results 3D-3D registration was superior to 2D-3D registration, with the highest mean centerline deviation being 1.67 ± 0.24 mm compared to 4.47 ± 0.92 mm. The highest absolute deviation was 3.25 mm for 3D-3D and 6.25 mm for 2D-3D registration. Differences for all angulations between registration techniques reached statistical significance. A decrease in registration accuracy was observed for c-arm angulations beyond 30° right anterior oblique/left anterior oblique. All landmarks (100%) were correctly positioned using 3D-3D registration compared to 81% using 2D-3D registration. Differences in accuracy between CT and MRI were acceptably small. Intra- and inter-reader reliability was excellent. Conclusion In the realm of registration techniques, the 3D-3D method proved more accurate than did the 2D-3D method. Based on our data, the use of 2D-3D registration for interventions with high registration quality requirements (e.g., fenestrated aortic repair procedures) cannot be fully recommended. Regarding imaging modalities, CTA and MRA can be used equivalently.

show abstract

“…In detail, they have reported an intra-operative displacement mostly in a cranial direction for the aortic bifurcation and in a ventral direction for the iliac one. Lalys et al (2019) evaluated how these deformations affects the fusion accuracy and they estimated a mean displacement error of 4.1 ± 2.4 mm at the level of the renal arteries. Moreover, they reported a correlation between the aortic neck angle and the fusion accuracy.…”

Section: Introductionmentioning

confidence: 99%

Prediction of guidewire-induced aortic deformations during EVAR: a finite element and in vitro study

Emendi,

Støverud,

Tangen

et al. 2023

Front. Physiol.

View full text Add to dashboard Cite

Introduction and aims: During an Endovascular Aneurysm Repair (EVAR) procedure a stiff guidewire is inserted from the iliac arteries. This induces significant deformations on the vasculature, thus, affecting the pre-operative planning, and the accuracy of image fusion. The aim of the present work is to predict the guidewire induced deformations using a finite element approach validated through experiments with patient-specific additive manufactured models. The numerical approach herein developed could improve the pre-operative planning and the intra-operative navigation.Material and methods: The physical models used for the experiments in the hybrid operating room, were manufactured from the segmentations of pre-operative Computed Tomography (CT) angiographies. The finite element analyses (FEA) were performed with LS-DYNA Explicit. The material properties used in finite element analyses were obtained by uniaxial tensile tests. The experimental deformed configurations of the aorta were compared to those obtained from FEA. Three models, obtained from Computed Tomography acquisitions, were investigated in the present work: A) without intraluminal thrombus (ILT), B) with ILT, C) with ILT and calcifications.Results and discussion: A good agreement was found between the experimental and the computational studies. The average error between the final in vitro vs. in silico aortic configurations, i.e., when the guidewire is fully inserted, are equal to 1.17, 1.22 and 1.40 mm, respectively, for Models A, B and C. The increasing trend in values of deformations from Model A to Model C was noticed both experimentally and numerically. The presented validated computational approach in combination with a tracking technology of the endovascular devices may be used to obtain the intra-operative configuration of the vessels and devices prior to the procedure, thus limiting the radiation exposure and the contrast agent dose.

show abstract

Identification of Parameters Influencing the Vascular Structure Displacement in Fusion Imaging during Endovascular Aneurysm Repair

Cited by 7 publications

References 27 publications

A State-of-the-Art Review of Intra-Operative Imaging Modalities Used to Quality Assure Endovascular Aneurysm Repair

A State-of-the-Art Review of Intra-Operative Imaging Modalities Used to Quality Assure Endovascular Aneurysm Repair

Accuracy of registration techniques and vascular imaging modalities in fusion imaging for aortic endovascular interventions: a phantom study

Prediction of guidewire-induced aortic deformations during EVAR: a finite element and in vitro study

Contact Info

Product

Resources

About