Graphical Assistance for Coronary Occlusion Visualization
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Solution Overview
Problem
In interventional medical procedures to open coronary artery occlusions, the distal portion of the artery cannot be visualized using traditional contrast agent injection methods, posing risks due to the total occlusion, and computed tomography data acquisition is not feasible in real-time.
Innovation Solution
A semi-automatic or automatic method that retrieves and visualizes three-dimensional CT image data, registers it with x-ray images, and provides real-time visualization during the procedure, allowing for optimal occlusion visualization with minimal user interaction.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Loss of information
If contrast agent injection is used in C-arm x-ray angiography, then the proximal portion of the coronary artery can be visualized, but the distal portion cannot be depicted due to total occlusion
Solution Approach 1:
The system performs preliminary registration of CT data with fluoroscopy images before the intervention procedure. This pre-alignment allows the distal artery portion to be visualized through overlaid CT data before the catheter reaches that area, eliminating the need to navigate blindly and reducing the risk of vessel perforation.
Solution Approach 2:
The invention uses CT image data as an intermediary to bridge the visualization gap caused by occlusion. The CT data, which shows the complete artery including distal portions, is registered and overlaid on fluoroscopy images, providing indirect visualization of areas that cannot be directly imaged with contrast agent injection.
2Loss of information
If computed tomography is used to show the vessel occlusion and distal portion, then complete visualization is achieved, but real-time acquisition during intervention is not possible
Solution Approach 1:
The CT data acquisition is performed preliminarily before the intervention procedure. This pre-acquired CT data is then registered with the fluoroscopy system and used throughout the procedure, providing complete anatomical information without requiring real-time CT acquisition during the intervention.
Solution Approach 2:
The system creates a digital copy of the arterial anatomy through CT scanning before the procedure. This 3D anatomical model is then overlaid on the 2D fluoroscopy images, allowing the complete arterial structure to be visualized throughout the procedure without requiring continuous CT scanning.
3Loss of information
If semi-automatic method with multiple steps is implemented, then optimal visualization is achieved, but user interaction complexity increases
Solution Approach 1:
The system performs automatic registration of CT data with fluoroscopy images using algorithmic matching of anatomical landmarks. This self-service approach eliminates the need for manual alignment by the operator, reducing interaction complexity while maintaining optimal visualization quality.
Solution Approach 2:
The system provides visual feedback by overlaying the registered CT data on fluoroscopy images in real-time. This immediate feedback allows the operator to verify the accuracy of the registration and the position of instruments, simplifying the overall operation while maintaining high visualization quality.
Data Source
AI summary
In a method and apparatus for graphical assistance in an interventional procedure to open an occlusion of a hollow organ of a patient a three-dimensional CT image data set of an examination region with the at least one hollow organ having the occlusion is retrieved and visualized segmentation data with segmentation data of the hollow organ at a display unit. At least two x-ray fluoroscopy images are acquired at different angulations the CT image data set is registered with at least two of the x-ray images. A number of fluoroscopy x-ray images are acquired during a time period, with real-time visualization of at least one x-ray fluoroscopy image and data of the CT image data set at the display unit. The steps are implemented individually and in sequence, and control options relating exclusively to the current step can be selected manually via a user interface depending on the step that is currently implemented, and only user inputs that are appropriate for the current step are accepted.