Abstract
Robot-assisted deployment of fenestrated stent grafts in Fenestrated Endovascular Aortic Repair (FEVAR) requires accurate geometrical alignment. Currently, this process is guided by 2D fluoroscopy, which is uninformative and error prone. In this paper, a real-time framework is proposed to instantiate the 3D shape of a fenestrated stent graft based on only a single low-dose 2D fluoroscopic image. Firstly, the fenestrated stent graft was placed with markers. Secondly, the 3D pose of each stent segment was instantiated by the RPnP (Robust Perspective-n-Point) method. Thirdly, the 3D shape of the whole stent graft was instantiated via graft gap interpolation. Focal-Unet was proposed to segment the markers from 2D fluoroscopic images to achieve semi-automatic marker detection. The proposed framework was validated on five patient-specific 3D printed phantoms of aortic aneurysms and three stent grafts with new marker placements, showing an average distance error of 1-3mm and an average angle error of 4 degree.
Highlights
E NDOVASCULAR Aortic Repair (EVAR), for the treatment of Abdominal Aortic Aneurysm (AAA), involves the insertion of compressed stent grafts via the femoral artery, advancement through the vasculature, subsequent device deployment, and exclusion of the aneurysmal wall
Semi-automatic marker detection and 3D stent graft shape instantiation were validated with errors shown
To illustrate the advantages of the proposed Focal U-Net over Weighted U-Net, a comparison of 78 images is shown in Section III-A, indicated by Intersection over Union (IoU)
Summary
E NDOVASCULAR Aortic Repair (EVAR), for the treatment of Abdominal Aortic Aneurysm (AAA), involves the insertion of compressed stent grafts via the femoral artery, advancement through the vasculature, subsequent device deployment, and exclusion of the aneurysmal wall. Blood flow is re-established through the deployed stent graft with reduced pressure on the diseased aneurysmal wall. The risk of rupture is abolished in the absence of endoleaks. For patients whose aneurysms involve or are adjacent to the renal and visceral vessels, Fenestrated Endovascular Aortic Repair (FEVAR) is necessary; this includes the use of a fenestrated stent graft with fen-. Manuscript received September 10, 2017; accepted January 7, 2018. Date of publication January 25, 2018; date of current version February 8, 2018. This letter was recommended for publication by Associate Editor G.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
