Scarponi Valentina, Verde Juan, Haouchine Nazim, Duprez Michel, Nageotte Florent, Cotin Stéphane
Mimesis Team Inria Strasbourg France.
ICube UMR 7357 University of Strasbourg Strasbourg France.
Healthc Technol Lett. 2024 Dec 7;11(6):392-401. doi: 10.1049/htl2.12108. eCollection 2024 Dec.
Endovascular interventions are procedures designed to diagnose and treat vascular diseases, using catheters to navigate inside arteries and veins. Thanks to their minimal invasiveness, they offer many benefits, such as reduced pain and hospital stays, but also present many challenges for clinicians, as they require specialized training and heavy use of X-rays. This is particularly relevant when accessing (i.e. cannulating) small arteries with steep angles, such as most aortic branches. To address this difficulty, a novel solution that enhances fluoroscopic 2D images in real-time by displaying virtual configurations of the catheter and guidewire is proposed. In contrast to existing works, proposing either simulators or simple augmented reality frameworks, this approach involves a predictive simulation showing the resulting shape of the catheter after guidewire withdrawal without requiring the clinician to perform this task. This system demonstrated accurate prediction with a mean 3D error of 2.4 1.3 mm and a mean error of 1.1 0.7 mm on the fluoroscopic image plane between the real catheter shape after guidewire withdrawal and the predicted shape. A user study reported an average intervention time reduction of 56 when adopting this system, resulting in a lower X-ray exposure.
血管内介入治疗是一种利用导管在动脉和静脉内操作来诊断和治疗血管疾病的程序。由于其微创性,它具有许多优点,如减轻疼痛和缩短住院时间,但也给临床医生带来了许多挑战,因为它们需要专门的培训并且大量使用X射线。在接入(即插管)角度陡峭的小动脉时,比如大多数主动脉分支,这一问题尤为突出。为了解决这一难题,本文提出了一种新颖的解决方案,通过显示导管和导丝的虚拟配置来实时增强荧光透视二维图像。与现有研究不同,现有研究要么提出模拟器,要么提出简单的增强现实框架,而这种方法涉及一种预测模拟,它能显示导丝拔出后导管的最终形状,而无需临床医生执行此操作。该系统显示出准确的预测结果,在导丝拔出后的真实导管形状与预测形状之间,荧光透视图像平面上的平均三维误差为2.4±1.3毫米,平均误差为1.1±0.7毫米。一项用户研究报告称,采用该系统时平均干预时间减少了56秒,从而降低了X射线暴露量。