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Improved image guidance of coronary stent deployment

机译:改善冠状动脉支架部署的图像引导

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Abstract: Accurate placement and expansion of coronary stents is hindered by the fact that most stents are only slightly radiopaque, and hence difficult to see in a typical coronary x-rays. We propose a new technique for improved image guidance of multiple coronary stents deployment using layer decomposition of cine x-ray images of stented coronary arteries. Layer decomposition models the cone-beam x-ray projections through the chest as a set of superposed layers moving with translation, rotation, and scaling. Radiopaque markers affixed to the guidewire or delivery balloon provide a trackable feature so that the correct vessel motion can be measured for layer decomposition. In addition to the time- averaged layer image, we also derive a background-subtracted image sequence which removes moving background structures. Layer decomposition of contrast-free vessels can be used to guide placement of multiple stents and to assess uniformity of stent expansion. Layer decomposition of contrast-filled vessels can be used to measure residual stenosis to determine the adequacy of stent expansion. We demonstrate that layer decomposition of a clinical cine x-ray image sequence greatly improves the visibility of a previously deployed stent. We show that layer decomposition of contrast-filled vessels removes background structures and reduces noise. !6
机译:摘要:大多数支架仅具有不透射线的特性,因此很难在典型的冠状X射线中看到,这阻碍了冠状动脉支架的准确放置和扩展。我们提出了一种新技术,该技术通过使用冠状动脉支架的X线电影的层分解来改善多个冠状动脉支架部署的图像指导。层分解将通过胸部的锥形束X射线投影建模为一组随着平移,旋转和缩放移动的叠加层。固定在导丝或输送球囊上的不透射线标记物具有可追踪的功能,因此可以测量正确的血管运动以进行层分解。除了时间平均层图像外,我们还导出了减去背景的图像序列,该序列去除了运动的背景结构。无对比血管的层分解可用于指导多个支架的放置和评估支架扩张的均匀性。造影剂填充血管的层分解可用于测量残余狭窄,以确定支架扩张的适当性。我们证明了临床电影X射线图像序列的层分解极大地改善了以前部署的支架的可见性。我们表明,对比剂填充的血管的层分解去除了背景结构并降低了噪声。 !6

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