Echo-endoscope biplane navigation system for endovascular aneurysm repair

Area of Science:

• Medical Imaging
• Vascular Surgery
• Endovascular Interventions

Background:

• Contrast medium use in endovascular interventions is limited by renal insufficiency and allergic reactions.
• Fluoroscopic guidance may not fully capture complex aortic lesion anatomy.
• Accurate anatomical navigation is crucial for successful endovascular procedures.

Purpose of the Study:

• To evaluate the feasibility of a bimodal monitoring system using echocardiography and endoscopy for endovascular intervention.
• To assess the system's accuracy in anatomical navigation for complex aortic lesions.
• To determine if this system can replace contrast medium in endovascular procedures.

Main Methods:

• Seven domestic swine underwent intravascular monitoring of the thoracoabdominal aorta.
• An intraluminal echo-endoscopic device, combining a balloon-tipped endoscope and echocardiogram, was utilized.
• The device provided both direct visual and cross-sectional ultrasonic views.

Main Results:

• Direct visualization readily identified anatomical landmarks of the thoracoabdominal aorta and aortic branches.
• Ultrasonography provided cross-sectional views of subintimal anatomies and branch angles crucial for stent graft implantation.
• Precise anatomical information of the target landing zone was obtained.

Conclusions:

• The echo-endoscope biplane navigation system offers potential for detailed anatomical visualization.
• This system can provide sufficient information for planning and executing endovascular interventions.
• It may eliminate the requirement for contrast medium in these procedures.