Stent Placement Planning via 3D-2D Image Overlay
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Solution Overview
Problem
During endovascular aneurysm repair procedures, stent grafts face challenges in maintaining position due to deformation caused by guide wires and catheters, leading to potential impairment or destruction, as they are difficult to accurately place in healthy vessel regions without obstructing important branches, especially in highly curved iliac vessels.
Innovation Solution
A method and system for planning support that involves recording and overlaying three-dimensional image data sets of hollow organs with two-dimensional images of guide devices, determining corrected positions, and estimating deformation energies to predict restoring forces, facilitating safer stent placement by displaying deformation energies color-coded for easy assessment.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If rigid guide wires and catheters are introduced into highly curved iliac vessels to perform endovascular aneurysm repair, then the stent graft can be delivered to the target position, but strong restoring forces act on the stent graft upon removal of the guide devices, causing deformation or movement that may impair or destroy the stent graft
Solution Approach 1:
The system performs preliminary action by calculating and displaying deformation energy maps before the actual stent graft deployment. The planning support system overlays preoperative 3D CT data with intraoperative 2D fluoroscopic images to predict deformation patterns in advance, allowing the interventionalist to select optimal landing zones that minimize restoring forces and avoid areas prone to stent graft deformation or movement.
2Productivity
If the stent graft is placed in highly curved iliac vessels to treat aneurysms extending into leg arteries, then the aneurysm can be repaired, but the stent graft is difficult to accurately place in healthy vessel regions without obstructing important vessel branches
Solution Approach 1:
The system implements feedback by continuously comparing preoperative 3D anatomical data with intraoperative 2D fluoroscopic images through overlaying. This real-time feedback loop allows the interventionalist to adjust stent graft positioning based on actual vessel anatomy and deformation patterns observed during the procedure, ensuring accurate placement in healthy regions while avoiding obstruction of important vessel branches.
Solution Approach 2:
The system transitions from 2D fluoroscopic imaging to 3D spatial understanding by overlaying 3D CT data with 2D fluoroscopic images. This dimensional transformation enables the interventionalist to visualize the stent graft's position relative to the vessel lumen and identify optimal landing zones in three-dimensional space, improving placement accuracy while avoiding vessel branches.
3Reliability
If preoperative 3D CT data is overlaid with intraoperative 2D fluoroscopic images to determine deformation, then the restoring forces can be predicted, but the system complexity increases due to image registration and processing requirements
Solution Approach 1:
The system uses an intermediary approach by employing automated image registration algorithms that serve as mediators between preoperative 3D CT data and intraoperative 2D fluoroscopic images. These algorithms automatically align the different image types, calculate deformation fields, and generate deformation energy maps, thereby reducing the manual complexity while maintaining high prediction accuracy.
Data Source
AI summary
Methods and systems are disclosed herein for improved safer planning support during interventional procedures for inserting stents into a hollow organ of a patient by a guide device. One method includes: providing or recording a three-dimensional image data set of the hollow organ in a first position; segmentation or providing a segmentation of the three-dimensional image data set; providing or recording a two-dimensional image of the guide device introduced into the hollow organ; overlaying the three-dimensional image data set with the two-dimensional image; determining at least one corrected position of one or more section(s) of the hollow organ respectively using the overlaying of the three-dimensional image data set with the two-dimensional image; and determining the respective deformation energy of the hollow organ in the section(s) for the case of removal of the guide device using the previously determined corrected position compared to the first position.