Planning image-guided endovascular interventions: guidewire simulation using shortest path algorithms

Abstract

Endovascular interventional procedures are being used more frequently in cardiovascular surgery. Unfortunately, procedural failure, e.g., vessel dissection, may occur and is often related to improper guidewire and/or device selection. To support the surgeon's decision process and because of the importance of the guidewire in positioning devices, we propose a method to determine the guidewire path prior to insertion using a model of its elastic potential energy coupled with a representative graph construction. The 3D vessel centerline and sizes are determined for a specified vessel. Points in planes perpendicular to the vessel centerline are generated. For each pair of consecutive planes, a vector set is generated which joins all points in these planes. We construct a graph representing these vector sets as nodes. The nodes representing adjacent vector sets are joined by edges with weights calculated as a function of the angle between the corresponding vectors (nodes). The optimal path through this weighted directed graph is then determined using shortest path algorithms, such as topological sort based shortest path algorithm or Dijkstra's algorithm. Volumetric data of an internal carotid artery phantom (Ø 3.5mm) were acquired. Several independent guidewire (Ø 0.4mm) placements were performed, and the 3D paths were determined using rotational angiography. The average RMS distance between the actual and the average simulated guidewire path was 0.7mm; the computation time to determine the path was 3 seconds. The ability to predict the guidewire path inside vessels may facilitate calculation of vessel-branch access and force estimation on devices and the vessel wall.