Stereotactic endovascular aortic navigation with a novel ultrasonic-based three-dimensional localization system

Area of Science:

• Medical Devices
• Interventional Radiology
• Vascular Surgery

Background:

• Endovascular aortic procedures are advancing, necessitating improved intraoperative imaging.
• Current imaging methods have limitations for complex endovascular techniques.
• A need exists for intuitive, 3D intraoperative imaging for endovascular repair.

Purpose of the Study:

• To describe and evaluate a novel ultrasonic-based localization system (ULS) for endovascular catheter tracking.
• To assess the feasibility of ULS-guided virtual navigation and stent deployment in an animal model.

Main Methods:

• Developed a 9F endovascular catheter with an ultrasonic transmitter for real-time ULS localization.
• Integrated ULS data with preoperative 3D CT images for virtual endoluminal navigation.
• Performed endovascular aortic stent deployment in swine using ULS guidance, validated against angiography and in situ stent placement.

Main Results:

• Successfully demonstrated real-time, virtual endoluminal tracking of the catheter tip on registered CT images.
• Achieved mean error <1 mm for ULS catheter tracking accuracy compared to angiography in the abdominal aorta.
• Deployed three aortic stents using ULS guidance with position errors ranging from -5.0 to +7.9 mm.

Conclusions:

• The ultrasonic localization system (ULS) shows feasibility for virtual image-guided endovascular aortic navigation.
• This 3D virtual navigation platform can aid stent deployment and potentially reduce radiation and contrast exposure.
• Future development will focus on miniaturization and accuracy improvements for clinical translation.