Instrument localisation for endovascular aneurysm repair: Comparison of two methods based on tracking systems or...

Area of Science:

• Medical engineering
• Interventional radiology
• Surgical navigation

Background:

• Current endovascular aneurysm repair (EVAR) relies on 2D imaging, X-rays, and contrast agents for instrument navigation.
• This method presents limitations in precision and potential risks associated with radiation and contrast media.

Purpose of the Study:

• To introduce and evaluate novel 3D instrument positioning methods for EVAR.
• To compare the accuracy of a fiber optic shape sensing approach with an image-based processing technique.

Main Methods:

• Developed a fiber optic shape sensing system combined with an electromagnetic sensor and preoperative CT.
• Introduced an image-based approach utilizing a 2D fluoroscopic image and a preoperative CT scan.

Main Results:

• The tracking-based method demonstrated average errors of 1.81–3.13 mm and maximum errors of 3.21–5.46 mm.
• The image-based approach showed higher average errors (3.07–6.02 mm) and maximum errors (8.05–15.75 mm).

Conclusions:

• The fiber optic tracking method shows significant promise for enhancing EVAR procedures.
• The image-based approach may be more suitable for smaller vessels due to increasing errors with vessel diameter.