Finite-element-based matching of pre- and intraoperative data for image-guided endovascular aneurysm repair

摘要

Endovascular repair of abdominal aortic aneurysms is a well-established technique throughout the medical and surgical communities. Although increasingly indicated, this technique does have some limitations. Because intervention is commonly performed under fluoroscopic control, two-dimensional (2D) visualization of the aneurysm requires the injection of a contrast agent. The projective nature of this imaging modality inevitably leads to topographic errors, and does not give information on arterial wall quality at the time of deployment. A specially-adapted intraoperative navigation interface could increase deployment accuracy and reveal such information, which preoperative three-dimensional (3D) imaging might otherwise provide. One difficulty is the precise matching of preoperative data (images and models) and intraoperative observations affected by anatomical deformations due to tool-tissue interactions. Our proposed solution involves a finite element-based preoperative simulation of tool/tissue interactions, its adaptive tuning regarding patient specific data, and the matching with intra-operative data. The biomechanical model was first tuned on a group of 10 patients and assessed on a second group of 8 patients.