LTSI-INSERM U1099, Université de Rennes 1, Rennes F-35000, France.
IEEE Trans Biomed Eng. 2013 May;60(5):1353-62. doi: 10.1109/TBME.2012.2235440. Epub 2012 Dec 20.
Endovascular repair of abdominal aortic aneurysms is a well-established technique throughout the medical and surgical communities. Although increasingly indicated, this technique does have some limitations. Because intervention is commonly performed under fluoroscopic control, 2-D visualization of the aneurysm requires the injection of a contrast agent. The projective nature of this imaging modality inevitably leads to topographic errors, and does not give information on arterial wall quality at the time of deployment. A specially adapted intraoperative navigation interface could increase deployment accuracy and reveal such information, which preoperative 3-D imaging might otherwise provide. One difficulty is the precise matching of preoperative data (images and models) and intraoperative observations affected by anatomical deformations due to tool-tissue interactions. Our proposed solution involves a finite-element-based preoperative simulation of tool-tissue interactions, its adaptive tuning regarding patient specific data, and the matching with intraoperative data. The biomechanical model was first tuned on a group of ten patients and assessed on a second group of eight patients.
血管内修复腹主动脉瘤在医学和外科学领域是一种成熟的技术。尽管这种技术的应用越来越多，但它确实存在一些局限性。由于介入治疗通常是在透视控制下进行的，因此需要注射造影剂才能对动脉瘤进行 2-D 可视化。这种成像方式的投影性质不可避免地会导致地形误差，并且在部署时无法提供关于动脉壁质量的信息。专门设计的术中导航界面可以提高部署的准确性，并提供术前 3-D 成像可能无法提供的信息。一个困难是如何精确匹配术前数据（图像和模型）和术中观察，因为工具-组织相互作用会导致解剖变形。我们提出的解决方案涉及基于有限元的术前工具-组织相互作用模拟，针对患者特定数据的自适应调整，以及与术中数据的匹配。该生物力学模型首先在一组 10 名患者上进行调整，并在第二组 8 名患者上进行评估。
