Feasibility of Augmented Reality-Guided Transjugular Intrahepatic Portosystemic Shunt.

Area of Science:

• Medical Imaging
• Surgical Navigation
• Interventional Radiology

Background:

• Transjugular intrahepatic portosystemic shunt (TIPS) creation is a complex procedure requiring precise vascular access.
• Current methods for guiding TIPS procedures can be challenging, potentially leading to complications.

Purpose of the Study:

• To evaluate the efficacy of an augmented reality (AR) navigation system for guiding endovascular puncture during TIPS procedures.
• To assess the accuracy and success rate of AR-guided portal vein access in preclinical models.

Main Methods:

• A novel AR navigation system was developed, integrating 3D liver models from CT scans with real-time electromagnetic tracking of puncture needles.
• The system overlaid 3D anatomical data onto a liver phantom and live beagle dogs via an AR head-mounted display.
• Puncture accuracy was validated using post-procedure imaging.

Main Results:

• The AR system achieved 100% success in guiding endovascular punctures to the target hepatic vein in 30 trials on a liver phantom.
• In live canine models, AR-guided punctures were highly successful, with all attempts reaching the target vein.
• Puncture times were efficient, ranging from 5-10 seconds in phantom experiments and 10-30 seconds in canine experiments.

Conclusions:

• Augmented reality-based navigation is a feasible tool for facilitating accurate and successful portal vein access in TIPS procedures.
• The study validates the potential of AR technology to enhance precision and safety in interventional radiology.
• Further clinical investigation is warranted to translate these preclinical findings into improved patient care for TIPS.