A Novel Surgical Software Tool to Improve the Physician-Modified Endograft Workflow

Area of Science:

• Vascular Surgery
• Medical Device Technology
• Surgical Planning Software

Background:

• Three-dimensional (3D) models aid fenestration placement in physician-modified endografts (PMEGs) for complex abdominal aortic aneurysms (CAAA).
• The punch card technique offers a 3D model benefit without the 3D printing workflow.
• Manual punch card design is time-consuming and prone to inaccuracies.

Purpose of the Study:

• To evaluate the performance of the EndoDraft software compared to manual punch card design for PMEG planning.
• To assess the speed and precision of software-assisted versus manual punch card creation.

Main Methods:

• An experimental study compared software-assisted and manual punch card creation using fenestration data from 38 patients undergoing elective FEVAR for CAAA.
• Planning time was recorded, and inaccuracies in vertical and circumferential fenestration positioning were measured for the manual technique.

Main Results:

• Software-assisted design took significantly less time (63.2 ± 21.5 seconds) compared to manual design (233.0 ± 40.3 seconds) (p<0.001).
• Manual punch card creation showed longitudinal imprecision ranging from 0.8 to 1.0 mm and circumferential errors from 0.4 to 0.6 mm.
• No significant difference in completion time was observed across the software's learning curve.

Conclusions:

• Software-assisted punch card design offers superior speed and precision for PMEG planning in CAAA FEVAR compared to manual methods.
• The freely available EndoDraft tool streamlines the PMEG-FEVAR workflow, reducing planning time and potential positioning errors.
• This automated approach enhances reproducibility, reduces cognitive load, and facilitates standardization among operators.