Vasculature View Selection for Device Navigation
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Solution Overview
Problem
During PCI procedures, clinicians face challenges in navigating guide-wires through complex cardiac vasculature due to the limitations of static 2D fluoroscopic images, which do not effectively represent the 3D geometry, leading to difficulties in accurately positioning devices like stents and balloons.
Innovation Solution
An apparatus that supplements real-time fluoroscopic images with pre-acquired angiographies, automatically selecting and displaying optimal 2D views to enhance the visualization of the 3D structure of the vasculature, using goodness of view standards to ensure clear and informative projections, without the need for 3D image calculations or additional X-ray exposure.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Loss of information
If static 2D fluoroscopic images are used for navigation, then real-time guidance is provided, but the 3D geometry of vasculature cannot be effectively represented
Solution Approach 1:
The patent displays multiple 2D angiographic images acquired from different projection angles simultaneously on the display device. By presenting views from various dimensions (different angulations and orientations), the system enables the clinician to mentally reconstruct the 3D vasculature geometry without requiring actual 3D image acquisition or processing, thus resolving the contradiction between representing 3D geometry and maintaining system simplicity.
2Loss of information
If multiple angiographic views from different angles are displayed, then better 3D visualization is achieved, but information processing complexity increases
Solution Approach 1:
The system pre-acquires a complete set of angiographic images from multiple projection angles before the intervention procedure begins. These images are stored and made available for display during the procedure. By performing the image acquisition and preparation in advance, the system avoids the complexity of real-time 3D reconstruction or dynamic image processing during the intervention, while still providing comprehensive multi-angle views for 3D visualization.
Solution Approach 2:
The system displays pre-acquired angiographic image copies from different projection angles alongside the live fluoroscopic image. Instead of processing or transforming the images in real-time, the system retrieves and displays static copies of previously acquired views, thereby providing comprehensive vasculature information without the computational burden of real-time 3D processing.
3Measurement precision
If 3D image calculations are performed in real-time, then accurate device positioning is achieved, but CPU time and intervention time increase
Solution Approach 1:
The system performs all necessary image acquisition and preparation in advance before the intervention procedure. By having pre-acquired angiographic images from multiple angles ready beforehand, the system eliminates the need for real-time 3D calculations during the procedure, thereby maintaining measurement precision through comprehensive pre-acquired data while avoiding the time loss associated with real-time computational processing.
4Loss of information
If 3D image volume acquisition is performed, then detailed vasculature structure is obtained, but radiation exposure and intervention time increase
Solution Approach 1:
The system acquires all necessary angiographic images from multiple projection angles before the intervention procedure begins. By completing the image acquisition in advance during a dedicated pre-procedure phase, the system obtains detailed vasculature information without requiring additional radiation exposure during the intervention itself, thus reducing the harmful radiation effects on the patient while maintaining comprehensive anatomical visualization.
Data Source
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Figure 2
AI summary
An apparatus configured to generate for display a plurality of vasculature (115) views (170a-c) alongside a live fluoroscopy image (190a). The views are selected in such a way that they allow visualizing the 3D structure of the vasculature segment in which the device (117) is currently navigating. The view is best relative to one or a weighted average of a plurality of goodness of view standards. As the device progresses and new fluoroscopy images (190b-c) are acquired, the views (170i-k) are updated accordingly.