Research project

Image guidance for endovascular aortic repair (EVAR)

Abdominal aortic aneurysms are pathological dilations of the aorta that constitute the most frequent structural aortic disease in humans. The main complication is a rupture of the aneurysm, associated with high mortality due to massive internal bleeding.

To prevent rupture, elective repair of aneurysms at high risk is performed. This can be done via open surgery or via minimally invasive endovascular aortic repair (EVAR), during which stent grafts that exclude the aneurysm sac from blood flow are placed in the aorta. This procedure is aided by 2D fluoroscopy and digital subtraction angiography (DSA).

As a preoperative CT is generally available, image fusion with the live fluoroscopic images can be used to provide additional 3D information and reduce the use of contrast agent during the intervention. However, patient movement and deformations due to devices positioned in the aorta may cause inaccuracies in the overlay.

The current focus of this project is on the automatic detection of relevant structures in fluoroscopic images that may influence the deformation of the aorta and the corresponding modelling of these influences by deforming the 3-D overlay.

Project manager:
Prof. Dr.-Ing. habil. Andreas Maier, PD Dr.-Ing. habil. Stefan Steidl, PD Dr. Markus Kowarschik, Dr. rer. nat. Marcus Pfister

Project participants:
Prof. Dr.-Ing. Katharina Breininger

Keywords:
image fusion; image guidance; endovascular; EVAR; aortic aneurysms; registration

Duration: 1.11.2015 - 31.10.2019

Sponsored by:
Siemens Healthcare GmbH, Forchheim

Contact:
Breininger, Katharina
Phone +49 9131 85 71154, E-Mail: katharina.breininger@fau.de

Publications

Breininger, Katharina ; Albarqouni, Shadi ; Kurzendorfer, Tanja ; Pfister, Marcus ; Kowarschik, Markus ; Maier, Andreas: Intraoperative stent segmentation in X-ray fluoroscopy for endovascular aortic repair. In: International Journal of Computer Assisted Radiology and Surgery 13 (2018), No. 8, pp 1221–1231
[doi>10.1007/s11548-018-1779-6]

Breininger, Katharina ; Pfister, Marcus ; Koutouzi, Giasemi ; Kowarschik, Markus ; Maier, Andreas: Estimation of femoral artery access location for anatomic deformation correction. In: Martin Skalej ; Christoph Hoeschen (Ed.) : 3rd Conference on Image-Guided Interventions & Fokus Neuroradiologie (3rd Conference on Image-Guided Interventions & Fokus Neuroradiologie Magdeburg 06.-07.11.2017). 2017, pp 23-24.

Breininger, Katharina ; Würfl, Tobias ; Kurzendorfer, Tanja ; Albarqouni, Shadi ; Pfister, Marcus ; Kowarschik, Markus ; Navab, Nassir ; Maier, Andreas: Multiple Device Segmentation for Fluoroscopic Imaging Using Multi-task Learning. In: Stoyanov, Danail ; Taylor, Zeike ; Balocco, Simone ; Sznitman, Raphael ; Martel, Anne ; Maier-Hein, Lena ; Duong, Luc ; Zahnd, Guillaume ; Demirci, Stefanie ; Albarqouni, Shadi ; Lee, Su-Lin ; Moriconi, Stefano ; Cheplygina, Veronika ; Mateus, Diana ; Trucco, Emanuele ; Granger, Eric ; Jannin, Pierre (Ed.) : Intravascular Imaging and Computer Assisted Stenting and Large-Scale Annotation of Biomedical Data and Expert Label Synthesis (Joint MICCAI-Workshops on Computing and Visualization for Intravascular Imaging and Computer Assisted Stenting (CVII-STENT) Granada, Spain 16.09.2018). Springer : Springer International Publishing, 2018, pp 19-27.