Patronus: patient-specific training setup for aortic aneurysm repair

Area of Science:

• Medical Simulation
• Biomedical Engineering
• Radiology

Background:

• Endovascular Aneurysm Repair (EVAR) training typically involves X-ray guidance, posing radiation risks to patients and staff.
• Patient-specific phantoms enhance simulator realism but often lack realistic imaging capabilities in radiation-free setups.
• Current 3D-printed vascular models for training require advanced imaging techniques for accurate representation.

Purpose of the Study:

• To develop PATRONUS, a prototype for patient-specific, radiation-free surgical training for EVAR.
• To integrate 3D printing and advanced imaging for realistic simulation of endovascular procedures.
• To reduce radiation exposure during surgical training for EVAR.

Main Methods:

• PATRONUS utilizes 3D-printed, transparent phantoms within a controlled imaging environment.
• Pseudo X-rays are generated via reconstructed radiographs, enhanced with virtual catheters and contrast agents.
• A complete pipeline includes 3D printing, phantom preparation, and online registration to patient CT data.

Main Results:

• The prototype successfully demonstrates a full pipeline for radiation-free EVAR simulation.
• An average registration error of 9.30 mm was achieved between the phantom and its digital twin.
• The simulator pipeline processes images at a rate of 1.059 seconds per image.

Conclusions:

• Advanced 3D printing and scene understanding enable realistic digital twin representations of vascular phantoms.
• The PATRONUS simulator facilitates a transition towards radiation-free endovascular surgical training.
• This prototype lays the groundwork for enhanced, patient-specific training in EVAR procedures.