Wearable headset-assisted fluoroscopic visualization during complex endovascular aortic repair

Area of Science:

• Vascular Surgery
• Medical Imaging Technology
• Surgical Navigation

Background:

• Complex endovascular aortic repair (EVAR) often necessitates simultaneous upper-extremity access.
• Arm-side operators in hybrid operating rooms face visualization challenges due to monitor obstruction and positioning.
• Existing secondary monitors may be inadequate for optimal intraoperative visualization.

Purpose of the Study:

• To introduce a wearable headset-assisted fluoroscopic visualization technique for complex EVAR procedures.
• To address the limited or obstructed view faced by arm-side operators in hybrid ORs.
• To evaluate the potential benefits of a personalized virtual fluoroscopy display.

Main Methods:

• A system using commercially available components: XREAL One Pro glasses, wireless HD multimedia interface transmitter, and DVI-to-HDMI connector.
• Live fluoroscopic images are displayed as a virtual monitor within the operator's field of view.
• The see-through display and adjustable shading maintain awareness of the operative field.

Main Results:

• The described technique provides an individualized virtual monitor for the arm-side operator.
• The system allows for stable three-degree-of-freedom or six-degree-of-freedom image display.
• Potential benefits include simplified OR setup, reduced monitor dependence, and improved ergonomics.

Conclusions:

• Wearable headset-assisted fluoroscopic visualization is a promising technique for complex EVAR, especially branched procedures.
• This technology may enhance precision during target-vessel catheterization and bridging stent deployment.
• Further research is required to assess procedural efficiency, radiation exposure, and safety outcomes.