Image Fusion and 3-Dimensional Roadmapping in Endovascular Surgery

Area of Science:

• Endovascular Surgery
• Medical Imaging
• Interventional Radiology

Background:

• Traditional endovascular surgery relies on 2D fluoroscopy for complex 3D vascular pathology.
• Limitations of 2D imaging necessitate advanced visualization techniques for improved surgical precision.

Purpose of the Study:

• To introduce and evaluate the benefits of image fusion techniques in endovascular surgery.
• To highlight the application of 3D patient-specific vascular roadmaps in guiding complex procedures.

Main Methods:

• Segmentation of 3D models from preoperative imaging (e.g., CT scans).
• Registration of preoperative 3D models with intraoperative cone-beam CT data.
• Codisplaying the 3D roadmap with live fluoroscopic images for real-time guidance.

Main Results:

• Image fusion demonstrated utility in procedures like endovascular aneurysm repair (EVAR) and carotid stenting.
• Significant reductions in radiation dose and iodinated contrast use were observed.
• Shorter procedure times were achieved using image fusion techniques.

Conclusions:

• Image fusion is an essential tool for planning and executing complex endovascular procedures.
• Future advancements may include automated adjustments for vessel deformation and more automated user steps.
• The technique offers substantial benefits, including reduced radiation and contrast, and improved efficiency.