A method, system and medium for digitalizing fenestration of a covered stent
By digitally reconstructing a three-dimensional model of the covered stent, the location of the branch vessel openings can be accurately determined and the branch stent can be constructed. This solves the problems of inaccurate positioning and long preoperative preparation time in the fenestration technique of covered stents, and achieves precise matching between the covered stent and the patient's anatomical structure, reducing surgical risks and improving treatment outcomes.
Patent Information
- Authority / Receiving Office
- CN · China
- Patent Type
- Applications(China)
- Current Assignee / Owner
- XIEHE HOSPITAL ATTACHED TO TONGJI MEDICAL COLLEGE HUAZHONG SCI & TECH UNIV
- Filing Date
- 2026-05-14
- Publication Date
- 2026-06-12
AI Technical Summary
Existing covered stent fenestration techniques lack accuracy in locating branch vessel openings, are difficult to perform in vivo, and carry risks of organ ischemia and distal embolism. External fenestration, on the other hand, is inaccurate in location, requires a long preoperative preparation time, has a high risk of infection, and relies on the surgeon's experience.
By acquiring medical imaging data, a digital three-dimensional model is reconstructed to accurately determine the location of branch vessel openings, generate the fenestrated structure of the covered stent, and construct a branch stent model as needed to achieve precise matching between the covered stent and the patient's anatomical structure.
It simplifies preoperative planning, improves the positioning accuracy of covered stents, reduces surgical difficulty and the risk of complications, improves long-term treatment outcomes, and meets individualized treatment needs.
Smart Images
Figure CN122182186A_ABST
Abstract
Description
Technical Field
[0001] This invention relates to the field of covered stent surgery technology, specifically to a digital covered stent fenestration method, system, and medium. Background Technology
[0002] Aortic diseases, mainly including aortic dissection and aortic aneurysm, are life-threatening vascular diseases. Currently, endovascular stent graft repair has become the mainstream minimally invasive method for treating these diseases. However, when the lesion involves important branches of the aorta (such as the celiac trunk, superior mesenteric artery, renal artery, or aortic arch branches), standard straight stent grafts can block the branch openings, leading to ischemia of the corresponding organs. To address this, the "fenestration" technique has been developed in clinical practice, which involves creating a window on the stent graft beforehand or during the procedure to restore blood flow to the branches.
[0003] Existing covered stent fenestration techniques are mainly divided into two categories. One is in vivo fenestration: this technique involves creating openings within the patient's body to locate and re-establish blood supply to the branch vessels. Typically, a complete covered stent is first placed at the corresponding lesion site via a delivery system. Then, through methods such as laser sintering, needle puncture, and balloon dilation, holes are created at the branch vessel openings of the covered stent, allowing blood flow to pass through these openings. Finally, a bridging stent is placed to complete the reconstruction of the branch vessels. Although this method can achieve individualized fenestration, it has significant drawbacks: temporary interruption of branch blood flow during the procedure poses a risk of organ ischemia; the in vivo operation is difficult, and the accuracy of positioning heavily depends on the surgeon's experience and image guidance; and covered stent debris may be generated during the fenestration process, leading to distal embolism, especially in areas supplying blood vessels to the brain, which carries a risk of stroke. Another type is external fenestration. This method involves pre-perforating the covered stent externally to correspond to the openings of branch vessels. The fenestrated stent is then loaded into a delivery system and released to the corresponding lesion site via interventional surgery. Simultaneously, the fenestration position of the stent needs to be adjusted to align with the branch vessel inlet, ensuring blood flow through the perforation into the branch vessel. External fenestration requires pre-determining the relative positions of the branches, typically using imaging techniques to determine the relative distances between the branch vessel openings. This distance is then mapped onto the covered stent to determine the corresponding dimensions and positions of the branches. Perforations are then made at the appropriate locations, achieving external customization of the fenestrated stent. While this technique avoids the risk of in vivo debris embolism, the stent deforms after implantation, and the pre-perforated external fenestration position may misalign with the branch vessel opening, leading to inaccurate positioning. Meanwhile, the custom-made covered stents for patients based on their anatomical characteristics are still in the experimental stage in China. Therefore, most extracorporeal fenestration surgeries require preoperative preparation by the surgeon. This involves first removing the stent from the delivery system, then performing fenestration, and finally loading it back into the delivery system for clinical use. During this process, the surgical preparation is not in a completely sterile environment, which may pose a risk of infection after implantation. Furthermore, the preoperative preparation time is lengthy, and the success of fenestration stent placement heavily depends on the surgeon's experience and skill.
[0004] Therefore, there is an urgent clinical need for a digital solution that can overcome the above-mentioned shortcomings, accurately determine the location of branch vessel openings, and customize a covered stent that is precisely matched to the lesion site, so as to simplify preoperative planning, improve the success rate of operation and long-term efficacy. Summary of the Invention
[0005] This application provides a digital laminated support window opening method, system, and medium to solve the above-mentioned problems.
[0006] In a first aspect, embodiments of this application provide a digitally-coated stent window opening method, comprising the following steps: Acquire medical imaging data of the target vascular region; based on the medical imaging data, determine the first specification parameters of the main covered stent to be implanted and the target anchoring position of the main covered stent in the blood vessel; based on the first specification parameters, perform three-dimensional modeling of the main covered stent to obtain a first model; based on the medical imaging data, perform three-dimensional modeling of the target blood vessel to obtain an aortic blood vessel model including branch vessels; Based on the target anchoring position, the first model and the aortic vessel model are virtually assembled to obtain the assembled vascular stent model; based on the vascular stent model, the projection area of the outline of the branch vessel opening on the aortic vessel model on the overlay surface of the first model is determined, and a windowing operation is performed on the projection area to generate a windowed structure. Based on the location and morphology of the branch vessels on the aortic vessel model, determine whether the fenestration structure requires a branch stent; if so, determine the second specification parameters of the branch stent based on the aortic vessel model, establish a branch stent model at the fenestration structure location corresponding to the first model based on the second specification parameters, and output the final stent model containing the branch stent model; if not, directly output the first model containing the fenestration structure.
[0007] In conjunction with the first aspect, in one embodiment, the medical imaging data is computed tomography (CT) vascular imaging data.
[0008] In conjunction with the first aspect, in one implementation, based on the medical imaging data, determining the first specification parameters of the main covered stent to be implanted specifically includes: The length of the lesion site, the available length and maximum inner diameter of the proximal healthy area, and the available length and maximum inner diameter of the distal healthy area are obtained based on the medical imaging data. The first specification parameters of the main body covered stent, determined based on the above data, include the proximal diameter, distal diameter, and length of the main body covered stent.
[0009] In conjunction with the first aspect, in one embodiment, determining the target anchoring position of the main covered stent in the blood vessel specifically includes: Within the available length of the proximal healthy zone, the target anchoring position is set at a first preset distance from the lesion site, so that the length of the main covered stent can completely cover the lesion site and the distal end of the main covered stent is located within the available length of the distal healthy zone.
[0010] In conjunction with the first aspect, in one embodiment, determining the projection area of the contour of the branch vessel opening on the aortic vessel model onto the lamina surface of the first model specifically includes: Using a geometric projection algorithm, the normal projection points of multiple discrete points on the contour of the branch vessel opening onto the covered surface of the first model are calculated. Based on multiple normal projection points, a closed projection profile is generated on the coated surface, and the area enclosed by the closed profile is the projection area.
[0011] In conjunction with the first aspect, in one implementation, performing a windowing operation on the projection area to generate a windowed structure specifically includes: The outline of the projected area is used as the cutting boundary; On the first model, the material corresponding to the projection area is removed from the first model by Boolean subtraction, thereby forming a window structure that matches the shape of the branch blood vessel opening.
[0012] In conjunction with the first aspect, in one implementation, determining the second specification parameters of the branch stent based on the aortic vascular model includes: Based on the opening direction and morphology of branch vessels in the aortic vessel model, the second specification parameters of the branch stent are determined.
[0013] In conjunction with the first aspect, in one embodiment, the second specification parameter includes: the opening direction and shape of the branch bracket.
[0014] Secondly, embodiments of this application provide a system based on a digitally applied scaffold window opening method, comprising: The data acquisition module is configured to: acquire medical imaging data of the target vascular region, and based on the medical imaging data, determine the first specification parameters of the main covered stent to be implanted and the target anchoring position of the main covered stent in the blood vessel. The modeling module is configured to: perform three-dimensional modeling of the main covered stent based on the first specification parameters to obtain a first model; perform three-dimensional modeling of the target blood vessel based on medical imaging data to obtain an aortic blood vessel model including branch vessels; virtually assemble the first model and the aortic blood vessel model based on the target anchoring position to obtain an assembled vascular stent model; and establish a branch stent model at the fenestration structure corresponding to the first model based on the second specification parameters. The processing module is configured to: determine the projection area of the outline of the branch vessel opening on the aortic vessel model onto the covered surface of the first model based on the vascular stent model; perform a fenestration operation on the projection area to generate a fenestrated structure; determine whether the fenestrated structure requires a branch stent based on the position and shape of the branch vessels on the aortic vessel model; if so, determine the second specification parameters of the branch stent based on the aortic vessel model and send an instruction to the modeling module to build a branch stent model; The output module is configured to output a final support model containing the branch support model and a first model containing the window structure.
[0015] Thirdly, embodiments of this application provide a medium storing a computer program, which, when executed, implements the digital film-coated stent window opening method as described in claim 1.
[0016] The beneficial effects of the technical solutions provided in this application include: 1. This application reconstructs a digital three-dimensional model from the patient's computed tomography angiography data and maps and matches it with the digital model of the membrane stent. This allows for precise determination of the branch vessel opening location, and then outputs the final stent model or a first model containing the fenestration structure. This enables visualization of the preoperative fenestrated covered stent, simplifies preoperative planning, and allows for the customization of a physical covered stent that precisely matches the lesion site based on the digital model during treatment. This ensures that the fenestration location of the manufactured stent perfectly matches the patient's anatomy, facilitating rapid and precise positioning of the branch vessel inlet during implantation, reducing the difficulty of surgical planning and operation, decreasing the occurrence of complications such as endoleak, and improving long-term treatment outcomes.
[0017] 2. In response to the diverse clinical realities of branch vessels, this application innovatively integrates a judgment node into the planning process. For branch vessels that require blood flow reconstruction, this application can determine their specifications based on the opening direction and morphology of the branch vessels on the aortic vessel model and establish a matching branch stent model at the fenestration structure corresponding to the first model. For cases where branch stent implantation is not required, the first model with precise fenestration can be output. This flexibility allows the method to cover a wider range of clinical indications and meet the precise needs of individualized treatment. Attached Figure Description
[0018] To more clearly illustrate the technical solutions in the embodiments of this application, the accompanying drawings used in the description of the embodiments will be briefly introduced below. Obviously, the accompanying drawings described below are only some embodiments of this application. For those skilled in the art, other drawings can be obtained based on these drawings without creative effort.
[0019] Figure 1 This is a schematic diagram illustrating the main steps of the present invention; Figure 2 This is a flowchart of the present invention; Figure 3 This is a schematic diagram of the aortic vessel model obtained and generated from CTA data according to Embodiment 1 of the present invention; Figure 4 This is an enlarged view of the aortic vessel model according to Embodiment 1 of the present invention; Figure 5 This is a schematic diagram of the first model constructed according to Embodiment 1 of the present invention; Figure 6 This is a schematic diagram of the first model and the aortic vessel model after assembly according to Embodiment 1 of the present invention; Figure 7 This is a schematic diagram of the window structure of the first model in Embodiment 1 of the present invention; Figure 8 This is an example diagram of the final support model in Embodiment 1 of the present invention; Figure 9This is an example diagram of the final support model in Embodiment 1 of the present invention; Figure 10 This is an example diagram of the final support model in Embodiment 1 of the present invention. Detailed Implementation
[0020] To enable those skilled in the art to better understand the present application, the technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only some embodiments of the present application, and not all embodiments. Based on the embodiments in the present application, all other embodiments obtained by those of ordinary skill in the art without creative effort are within the scope of protection of the present application.
[0021] Example 1: Please see Figure 1 and Figure 2 Embodiment 1 of this application provides a digitally coated support window opening method, including the following steps: S1. Obtain medical imaging data of the target vascular region; based on the medical imaging data, determine the first specification parameters of the main covered stent to be implanted and the target anchoring position of the main covered stent in the blood vessel; based on the first specification parameters, perform three-dimensional modeling of the main covered stent to obtain a first model; based on the medical imaging data, perform three-dimensional modeling of the target blood vessel to obtain an aortic blood vessel model including branch vessels. S101, Acquiring medical imaging data and constructing an aortic vessel model: like Figure 3 As shown, the medical imaging data is preferably computed tomography angiography (CTA) data; The acquired CTA data is imported into dedicated medical image processing software, preferably DetecMicro vascular interventional surgery planning software in this embodiment. Based on the patient's CTA data, the vascular structure is refined and reconstructed using graphic image algorithms, and an aortic vascular model including branch vessels is generated. Figure 4 As shown; S102, Determine the first specification parameters and target anchoring position of the main film-coated support: The aortic vascular model is imported into data processing software, preferably 3mensio Vascular software in this embodiment, to automatically detect the centerline or three-dimensional biclinic to identify and measure the following key areas: Lesion area: The length range used to identify the lesion site; Proximal healthy zone (neck): In the proximal region of the lesion site, find a relatively healthy and sufficiently long area of the blood vessel wall, and obtain its usable length data and maximum inner diameter data; Distal healthy area: Similarly, in the distant area of the lesion site, find a relatively healthy and long section of blood vessel wall and obtain its usable length data and maximum inner diameter data.
[0022] S103, Determine the first specification parameters and target anchoring position: ① Based on the above measurement data, the first specification parameters of the main film-coated support are determined: Proximal diameter: It needs to be compatible with the maximum inner diameter of the proximal healthy area to facilitate the proximal fixation of the main covered stent; Distal diameter: It needs to be compatible with the maximum inner diameter of the distal healthy area to facilitate the distal fixation of the main covered stent; Main stent length: It must be sufficient to ensure that the main stent length completely covers the lesion site.
[0023] ② Determine the target anchoring position: The target anchoring location is the point in the blood vessel where the proximal end of the main covered stent needs to be precisely placed; This location is determined within the available length data range of the proximal healthy zone; one specific method for determination in this embodiment is: Within the available length of the proximal healthy zone, the target anchoring position is set at a first preset distance from the lesion site. In this embodiment, the first preset distance is 15mm. In actual surgical planning, it needs to be dynamically adjusted according to the actual length of the proximal and distal healthy areas, the length and shape of the lesion, to ensure that the stent can fully cover the lesion while the proximal and distal ends can obtain sufficient and stable anchorage.
[0024] S104: Construct the first model; Based on the first specification parameters determined in step S103, a three-dimensional geometric model representing the main body covered scaffold is created as the first model; The first model in this embodiment is as follows: Figure 5 It should be noted that the present invention does not limit the specific generation method of the first model. Its core is that the final generated model must be geometrically matched with the first specification parameters determined in S103 for subsequent virtual assembly.
[0025] S2. Based on the target anchoring position, the first model and the aortic vessel model are virtually assembled to obtain the assembled vascular stent model; based on the vascular stent model, the projection area of the outline of the branch vessel opening on the aortic vessel model onto the overlay surface of the first model is determined, and a windowing operation is performed on the projection area to generate a windowed structure. S201: Model assembly; The first model generated in step S104 and the aortic vessel model reconstructed in step S102 are imported into 3D computer-aided design (CAD) software (such as Materialise Mimics, Siemens NX, Blender, etc.). Using the center point of the proximal end face of the first model as a reference, a 3D translation transformation is performed to make it coincide with the target anchoring position coordinates determined in step S103. This allows the first model to be precisely placed inside the aortic vessel model, forming the assembled vascular stent model. In this embodiment, the assembled vascular stent model is as follows: Figure 6 As shown; S202: Open the window; In the assembled vascular stent model, the edge contour of the branch vessel opening on the arterial vessel model is extracted. This edge is a closed spatial curve on the surface of the aortic vessel model, which is composed of a series of three-dimensional spatial points. The average normal vector direction of the surface of the aortic vessel model at the branch opening is calculated using the normal projection algorithm. Along this normal direction, each point on the above spatial curve is vertically projected onto the outer surface of the first model located inside it. Connecting all the projection points forms a new closed spatial curve on the covered surface. The newly generated closed spatial curve delineates a surface patch on the stent covered surface. This surface patch is extracted and defined as the projection region. The boundary curve of the aforementioned projection area is set as the cutting line. In the CAD software, a Boolean subtraction operation is performed on the first model to remove the material corresponding to the projection area, thereby forming a window structure adapted to the shape of the branch vessel opening, such as... Figure 7 As shown.
[0026] S3. Determine whether a branch stent is needed for the fenestration structure based on the location and morphology of the branch vessels on the aortic vessel model. If yes, determine the second specification parameters of the branch stent based on the aortic vessel model, establish a branch stent model at the fenestration structure location corresponding to the first model based on the second specification parameters, and output the final stent model containing the branch stent model. If no, directly output the first model containing the fenestration structure.
[0027] Determine whether a branch stent is needed for the fenestration structure based on the location and morphology of branch vessels on the aortic vessel model; In a preferred embodiment of the present invention, determining whether a branched stent is needed for the fenestration structure based on the location and morphology of branch vessels on an aortic vessel model specifically includes the following steps: Based on the anatomical perspective of the aortic vascular model, the system automatically or through user interaction identifies and extracts the following key anatomical and planning parameters: Location of branch vessel openings: Determine the coordinates of the center point emanating from the aortic wall of the branch vessel in three-dimensional space; Lesion boundary: The spatial extent of aortic lesions (such as aneurysms and dissections) in a three-dimensional model; Branch vessel extension direction: The centerline of the branch vessel from its opening, and its main axis at that location is determined; Treatment device delivery route direction: Based on the preoperatively planned device delivery route (such as retrograde femoral artery approach), calculate the tangential direction of the route near the branch vessel opening, and use it as the access direction; The extracted parameters are compared with preset clinical rule thresholds. If any of the following conditions are met, it means that a branch stent needs to be configured at the corresponding fenestration structure in the first model: ① The three-dimensional coordinates of the branch vessel openings are located within the spatial range of the lesion area; ② Calculate the shortest spatial distance from the branch vessel opening to the boundary of the lesion area. If the distance is less than the first preset threshold, it means that a branch stent needs to be configured.
[0028] In this embodiment, the first preset threshold is 10mm. This threshold is usually set based on clinical experience to identify branches that, although not directly caused by the lesion, are too close and may affect blood flow or anchoring stability after being covered by the stent. ③ Calculate the spatial angle between the branch vessel extension direction and the preset therapeutic device delivery route direction. If this angle is greater than the second preset threshold, it means that a branch stent needs to be configured.
[0029] In this embodiment, the second preset threshold is 60°. This threshold usually takes into account the feasibility and safety of the device passing through. If the angle is too large, it may lead to difficulties in the delivery of the branch stent, inaccurate positioning, or a decrease in long-term patency. Therefore, it is necessary to reconstruct a better blood flow channel by configuring an embedded branch stent.
[0030] It should be noted that the specific values mentioned in the first and second preset thresholds above are for illustrative purposes only. In actual clinical applications, these thresholds are not fixed. Physicians or planning engineers can flexibly adjust them based on the specific patient's anatomical characteristics, the nature of the lesion, the performance of the selected instruments, and the latest clinical guidelines or surgical experience.
[0031] ① If it is determined that a branch support is needed: Based on the opening direction and morphology of the branch vessels in the aortic vascular model, the second specification parameters of the branch stent are determined. The second specification parameters include: Branch support opening direction: whether the support opening faces the proximal or distal end of the first model; The shape of the branch support: the specific shape located inside the first model; Based on the second specification parameters determined above, construct the branch support model at the corresponding window structure position on the first model, and output the final support model containing the branch support model. This embodiment provides an example diagram of the final support model as follows: Please see Figure 9 The branch support model of the final support model has its support opening facing the proximal end of the first model, and each window structure is provided with a branch support model. Please see Figure 10 The final stent model has a branch stent model with the stent opening facing the proximal end of the first model, and there is a fenestration structure without a branch stent model.
[0032] ②If branch supports are not required: Then directly output the first model containing the window structure in step S202, such as Figure 8 As shown, the window structure of the first model does not have a branch support model. Medical staff can customize the physical covered stent based on the two models mentioned above, which helps to quickly and accurately locate the branch vessel inlet during implantation, reduce the difficulty of surgical planning and operation, reduce the occurrence of complications such as endoleak, and improve long-term treatment results. Furthermore, this flexibility allows the method to cover a wider range of clinical indications and meet the precise needs of individualized treatment.
[0033] Example 2: Embodiment 2 of this application provides a digital laminated stent fenestration system for executing the method of Embodiment 1. This system adopts a modular design, and through the collaborative work of each module, achieves fully automated and intelligent planning from data acquisition to the final stent model output. The system specifically includes: Data acquisition module: As the initial input interface of the system, it is mainly used to acquire medical imaging data of the patient's target vascular area and determine the first specification parameters and anchoring position of the main covered stent based on the data; Specifically, this module is configured to receive and read medical imaging data, preferably computed tomography angiography (CTA) data, which can be directly imported from a hospital PACS system or loaded from a storage medium. Based on the imported medical imaging data, the module automatically identifies and measures the following key anatomical information by interacting with built-in or external image processing algorithms (e.g., calling measurement functions in software like 3mensioVascular): The length and region of the lesion; Available length and maximum inner diameter data for the proximal healthy region (neck); Available length data and maximum inner diameter data for the distal health zone.
[0034] Based on the above measurement results, the module automatically calculates and determines: The first specification parameters include the proximal diameter of the covered stent that matches the inner diameter of the proximal healthy area, the distal diameter that matches the inner diameter of the distal healthy area, and the length of the main stent that can completely cover the lesion area.
[0035] Target anchoring position: Within the available length of the proximal healthy zone, the target anchoring position that the proximal end of the main covered stent needs to be precisely placed in the blood vessel is automatically calculated according to preset rules; This module packages the determined first specification parameters with the target anchoring position data and sends them to the modeling module for processing.
[0036] Modeling module: It is responsible for constructing various 3D models based on input parameters and performing virtual assembly, such as: Vascular model construction: After receiving medical image data, this module calls a 3D reconstruction engine (e.g., integrating algorithms similar to DetecMicro software) to automatically segment and 3D reconstruct the target blood vessel, generating a high-precision aortic blood vessel model including branch vessels; First model construction: Based on the first specification parameters sent by the data acquisition module, the module automatically generates a three-dimensional geometric model of the main body covered stent that precisely matches the parameters, i.e., the first model. This process can be completed automatically by using a parametric modeling library or by using a stent specification template, or it can be created manually. Virtual assembly: After acquiring the target anchoring position coordinates sent by the data acquisition module, the module assembles the first model with the aortic blood vessel model in three-dimensional space. Specifically, taking the center point of the proximal end face of the first model as the reference point, the module makes it coincide with the target anchoring position through three-dimensional coordinate transformation, and places the first model into the aortic blood vessel model, thereby generating the assembled vascular stent model. Branch support model construction: Upon receiving an instruction from the processing module, the module automatically constructs and merges a three-dimensional model of the branch support based on the second specification parameters contained in the instruction and the window structure portion already generated on the first model. Processing module: It is responsible for performing the key fenestration operation and determining whether a branch stent is needed. Specifically: This module receives the assembled vascular stent model from the modeling module, automatically identifies and extracts the edge contour (three-dimensional closed space curve) of the branch vessel opening on the aortic vessel model, calculates the average normal vector of the vessel wall surface at the opening, and projects all points on the contour line vertically along the normal direction onto the inner first model covering surface to form the projection area boundary curve. Using the aforementioned projection boundary curve as the cutting line, a Boolean subtraction operation is performed on the first model to remove the material corresponding to the projection area, thereby generating a fenestration structure on the digital scaffold that precisely matches the patient's anatomical structure.
[0037] Branch stent decision: Based on the location of the branch vessel opening, the boundary of the lesion area, the extension direction of the branch vessel and the preset delivery route of the treatment device in the aortic vessel model, and based on the preset first preset threshold and the preset second preset threshold, the specific logic is as shown in step S3 of Example 1.
[0038] Parameter determination and command transmission: If it is determined that a branch stent is needed, the second specification parameters required for the branch stent are automatically calculated based on the aortic vessel model. Then, the module sends a command to the modeling module, which contains these second specification parameters, triggering the modeling module to build the branch stent model. If it is determined that no branch support is needed, the output module is directly notified to output the first model containing only the window structure.
[0039] Output module: It is used to output the planned digital stent model in a usable format for custom-made covered stent physical objects; specifically: this module receives the final model data from upstream of the system. When the processing module determines that a branch stent is needed, it receives the final stent model containing the branch stent model from the modeling module; when it determines that a branch stent is not needed, it receives the first model containing only the fenestration structure from the processing module. This module converts the received 3D model into a common file format that can be read by downstream manufacturing or software, such as STL, STEP, or IGES format.
[0040] Example 3: Embodiment 3 of this application provides a computer-readable storage medium having a computer program (instructions) stored thereon. When the computer program is executed on one or more processors, it causes a computer or a device with data processing capabilities (e.g., a server, workstation, personal computer, or dedicated surgical planning terminal) to implement the digital covered stent fenestration method of Embodiment 1. Specifically, when a program in the storage medium (e.g., hard drive, solid-state drive, USB flash drive, optical disc, or cloud storage) is loaded and executed, it controls the computer system to perform the following operations in sequence: Data acquisition and processing: Read the patient's CTA medical image data, automatically analyze and determine the first specification parameters of the main body covered stent to be implanted and its target anchoring position in the blood vessel; Model construction and assembly: Based on the specifications, a first model of the main covered stent is generated; based on CTA data, an aortic vessel model including branch vessels is reconstructed; Based on the target anchoring position, the first model and the aortic blood vessel model are precisely virtually assembled in three-dimensional space; Perform the windowing operation: In the assembled model, project the outline of the branch vessel openings on the aortic vessel model onto the covering surface of the first model, and cut out the matching windowing structure at that location through three-dimensional editing operations such as Boolean operations. Decision and branch modeling: Based on the location of branch vessel openings, lesion area boundaries, branch vessel extension directions, and preset treatment device delivery routes in the aortic vessel model, and according to the first and second preset thresholds, it is determined whether a branch stent is needed at the fenestration site. If so, the second specification parameters of the branch stent are automatically determined, and a branch stent model is built at the fenestration site; if not, the first model containing the fenestration structure is directly output. Output: Generates a first model containing the window structure or a final support model containing the branch support model, which is used to guide the physical customization of the support.
[0041] By embedding the method in a storage medium, this personalized and precise surgical planning capability can be productized, standardized, and widely deployed. Medical personnel do not need to delve into the details of the underlying algorithms; they only need to run the program on a computing device with the program installed, input the patient's image data, and quickly obtain a customized digital solution for fenestration stents. This greatly reduces the technical barrier to use and improves the accessibility and efficiency of surgical planning.
[0042] In the description of this application, it should be noted that the terms "upper," "lower," etc., indicating the orientation or positional relationship are based on the orientation or positional relationship shown in the accompanying drawings, and are only for the convenience of describing this application and simplifying the description, and do not indicate or imply that the device or element referred to must have a specific orientation, or be constructed and operated in a specific orientation, and therefore should not be construed as a limitation of this application. Unless otherwise expressly specified and limited, the terms "installed," "connected," and "linked" should be interpreted broadly. For example, they can refer to a fixed connection, a detachable connection, or an integral connection; they can refer to a mechanical connection or an electrical connection; they can refer to a direct connection or an indirect connection through an intermediate medium; they can refer to the internal communication between two elements. For those skilled in the art, the specific meaning of the above terms in this application can be understood according to the specific circumstances.
[0043] It should be noted that in this application, relational terms such as "first" and "second" are used merely to distinguish one entity or operation from another, and do not necessarily require or imply any such actual relationship or order between these entities or operations. Furthermore, the terms "comprising," "including," or any other variations thereof are intended to cover non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements includes not only those elements but also other elements not expressly listed, or elements inherent to such a process, method, article, or apparatus. Without further limitations, an element defined by the phrase "comprising one..." does not exclude the presence of other identical elements in the process, method, article, or apparatus that includes said element.
[0044] The above description is merely a specific embodiment of this application, enabling those skilled in the art to understand or implement this application. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the general principles defined herein may be implemented in other embodiments without departing from the spirit or scope of this application. Therefore, this application is not to be limited to the embodiments shown herein, but is to be accorded the widest scope consistent with the principles and novel features claimed herein.
Claims
1. A method for opening windows in a digitally laminated support structure, characterized in that, Includes the following steps: Acquire medical imaging data of the target vascular region; based on the medical imaging data, determine the first specification parameters of the main covered stent to be implanted and the target anchoring position of the main covered stent in the blood vessel; based on the first specification parameters, perform three-dimensional modeling of the main covered stent to obtain a first model; based on the medical imaging data, perform three-dimensional modeling of the target blood vessel to obtain an aortic blood vessel model including branch vessels; Based on the target anchoring position, the first model and the aortic vessel model are virtually assembled to obtain the assembled vascular stent model; based on the vascular stent model, the projection area of the outline of the branch vessel opening on the aortic vessel model on the overlay surface of the first model is determined, and a windowing operation is performed on the projection area to generate a windowed structure. Whether the fenestration structure requires a branch stent is determined based on the location and morphology of the branch vessels on the aortic vessel model. If yes, then the second specification parameters of the branch stent are determined based on the aortic vessel model, and a branch stent model is established at the fenestration structure corresponding to the first model based on the second specification parameters, and the final stent model containing the branch stent model is output; if no, then the first model containing the fenestration structure is directly output.
2. The digital film-coated bracket window opening method according to claim 1, characterized in that, The medical imaging data is computed tomography (CT) vascular imaging data.
3. The digital film-coated bracket window opening method according to claim 1, characterized in that, Based on the aforementioned medical imaging data, the first specification parameters of the main covered stent to be implanted are determined, specifically including: Based on the medical imaging data, the length of the lesion site, the available length and maximum inner diameter of the proximal healthy area, and the available length and maximum inner diameter of the distal healthy area are obtained. The first specification parameters of the main body covered stent, determined based on the above data, include the proximal diameter, distal diameter, and length of the main body covered stent.
4. The digital film-coated support window opening method according to claim 3, characterized in that, Determining the target anchorage position of the main covered stent in the blood vessel specifically includes: Within the available length of the proximal healthy zone, the target anchoring position is set at a first preset distance from the lesion site, so that the length of the main covered stent can completely cover the lesion site and the distal end of the main covered stent is located within the available length of the distal healthy zone.
5. The digital film-coated bracket window opening method according to claim 1, characterized in that, The determination of the projection region of the outline of the branch vessel openings on the aortic vessel model onto the lamina surface of the first model specifically includes: Using a geometric projection algorithm, the normal projection points of multiple discrete points on the contour of the branch vessel opening onto the covered surface of the first model are calculated. Based on multiple normal projection points, a closed projection profile is generated on the coated surface, and the area enclosed by the closed profile is the projection area.
6. The digital film-coated bracket window opening method according to claim 1, characterized in that, The step of performing a windowing operation on the projection area to generate a windowed structure specifically includes: The outline of the projected area is used as the cutting boundary; On the first model, the material corresponding to the projection area is removed from the first model by Boolean subtraction, thereby forming a window structure that matches the shape of the branch blood vessel opening.
7. The digital film-coated bracket window opening method according to claim 1, characterized in that, The determination of the second specification parameters of the branch stent based on the aortic vascular model includes: Based on the opening direction and morphology of the branch vessels on the aortic vessel model, the second specification parameters of the branch stent are determined. The second specification parameters include the opening direction and morphology of the branch stent.
8. The digital film-coated bracket window opening method according to claim 1, characterized in that, The determination of whether the fenestrated structure requires a branched stent based on the location and morphology of branch vessels on the aortic vascular model specifically includes: The location of the branch vessel openings and the extension angle of the branch vessels relative to the aorta are obtained in the aortic vessel model. If any of the following conditions are met, it is determined that a branch support needs to be configured for the window opening structure: The branch vessel opening is located within the lesion area; The shortest distance between the branch vessel opening and the edge of the lesion area is less than a first preset threshold. The angle between the extension direction of the branch vessel and the preset delivery route of the treatment device is greater than a second preset threshold.
9. A system based on the digital film-coated scaffold window opening method according to claim 1, characterized in that, include: The data acquisition module is configured to: acquire medical imaging data of the target vascular region, and based on the medical imaging data, determine the first specification parameters of the main covered stent to be implanted and the target anchoring position of the main covered stent in the blood vessel. The modeling module is configured to: perform three-dimensional modeling of the main covered stent based on the first specification parameters to obtain a first model; perform three-dimensional modeling of the target blood vessel based on medical imaging data to obtain an aortic blood vessel model including branch vessels; virtually assemble the first model and the aortic blood vessel model based on the target anchoring position to obtain an assembled vascular stent model; and establish a branch stent model at the fenestration structure corresponding to the first model based on the second specification parameters. The processing module is configured to: determine the projection area of the outline of the branch vessel opening on the aortic vessel model onto the lamina surface of the first model based on the vascular stent model; perform a fenestration operation on the projection area to generate a fenestrated structure; and determine whether the fenestrated structure requires a branch stent based on the position and morphology of the branch vessels on the aortic vessel model. If so, the second specification parameters of the branch stent are determined based on the aortic vessel model, and an instruction to build the branch stent model is sent to the modeling module. The output module is configured to output a final support model containing the branch support model and a first model containing the window structure.
10. A medium storing a computer program, characterized in that, When the program is executed, it implements the digital film-coated bracket window opening method as described in claim 1.