An image-guided surgery system to aid endovascular treatment of complex aortic aneurysms: Description and initial clinical experience

Abstract

We have designed an image guidance system to aid complex aortic aneurysm procedures. The system is based around an intensity-based 2D-3D rigid registration algorithm which accurately aligns a vertebra in the preoperative CT to interventional fluoroscopy. A 3D surface rendering of the aorta and relevant target vessels is then overlaid onto the fluoroscopy to aid guidance during the procedure. We report results from use of the system during twenty three procedures over a ten month period. Results showed the system to have an overall failure rate of 5.8%, which was mostly caused by errors in determining a starting position (misidentifying a vertebra). In 78% of cases our method was within our target accuracy of 3mm. Non-rigid deformation caused by the interventional instruments is believed to be the main reason for larger errors. In twenty one of the twenty three cases the surgeon rated the system as aiding the procedure. © 2011 Springer-Verlag.