Patronus: patient-specific training setup for aortic aneurysm repair

Surgical training for Aortic Repair (EVAR) on simulators holds the potential to reduce radiation of the X-ray-guided procedure. Precision and realism of training simulators increases significantly with the use of patient-specific phantoms. However, radiation-free setups utilizing 3D-printed anatomies lack realistic imaging.

We propose PATRONUS, a hardware and software prototype for patient-specific, radiation-free surgical training for EVAR. 3D printed, transparent phantoms are imaged inside a black box which is accessed from the outside. Pseudo X-rays are generated through reconstructed radiographs, which are enhanced by virtual catheters and contrast agent.

Our prototype demonstrates a complete pipeline including a 3D printing workflow, phantom preparation, online registration of phantoms to the patient CT and pseudo X-ray generation. We report an average registration error (RMSE) of the scene inside the simulator to the digital twin of $9.30\text{mm}$ . The entire simulator pipeline takes $1.059\text{s}$ to execute per image.

State-of-the-art techniques for scene understanding and 3D printing enable the transition from simulated interventions on 3D printed vascular phantoms under cameras to a digital twin representation in the CT regime. The PATRONUS simulator prototype thus provides a foundation for radiation-free, realistic endovascular surgical training with patient-specific phantoms.