Intraoperative position system guided with augmented reality improves the learning curve of endovascular navigation in endovascular-naïve operators.

Objective: This study aimed to compare the completion of gate cannulation task performed by participants of varying experience using fluoroscopy, the Intraoperative Positioning System (IOPS)-a United States Food and Drug Administration-cleared endovascular navigation system that has been developed to reduce dependence on fluoroscopy-or an investigational augmented reality electromagnetic navigation technology based on IOPS.

Methods: The task consisted in the cannulation of the gate of a GORE Excluder AAA endoprosthesis bifurcated aortic stent graft (W.L.

Nonfluoroscopic 3D Image Guidance System Reduces Navigation Times Through Five 3D-Printed Iliofemoral Vascular Phantoms.

Purpose: To assess the potential adjunctive role of a 3D electromagnetic (EM) navigational system for use in above-knee vessels afflicted with peripheral artery disease (PAD). Peripheral artery disease can be challenging to operators encountering significant vessel tortuosity, calcium, and stenoses, which may require prolonged procedure times and excessive use of nephrotoxic iodinated contrast when performed with conventional fluoroscopy.

Materials And Methods: Following appropriate ethical oversight, five 3D-printed bench phantoms modeling tortuous calcified PAD were created based on source CTA (computed tomography angiography) data sets from real patients.

Branched Endovascular Thoracoabdominal Aneurysm Repair Under Electromagnetic Guidance in an in Vitro Model.

Purpose: We report a new approach to perform endovascular treatment of thoracoabdominal aneurysms under electromagnetic navigation guidance using a modified system (IOPS; Centerline Biomedical, Inc., Cleveland, OH, USA) and a modified branched endograft (E-nside TAAA Multibranch Stent Graft System; Artivion Inc., Kennesaw, GA, USA).

Successful endovascular treatment of severe chronic mesenteric ischemia facilitated by intraoperative positioning system image guidance.

We report our initial experience using the intraoperative positioning system (IOPS), a novel endovascular navigation system that does not require contrast or radiation, in the treatment of chronic mesenteric ischemia (CMI). We used IOPS to help treat three of four consecutive patients with CMI. Technical problems prevented successful use in one patient.

Three-Dimensional Holographic Guidance, Navigation, and Control (3D-GNC) for Endograft Positioning in Porcine Aorta: Feasibility Comparison With 2-Dimensional X-Ray Fluoroscopy.

Objectives: Intraprocedural deployment of endovascular devices during complex aortic repair with 2-dimensional (2D) x-ray fluoroscopic guidance poses challenges in terms of accurate delivery system positioning and increased risk of x-ray radiation exposure with prolonged fluoroscopy times, particularly in unfavorable anatomy. The objective of this study was to assess feasibility of using an augmented reality (AR) system to position and orient a modified aortic endograft delivery system in comparison with standard fluoroscopy.

Materials And Methods: The 3-dimensional guidance, navigation, and control (3D-GNC) prototype system was developed for eventual integration with the Intra-Operative Positioning System (IOPS, Centerline Biomedical, Cleveland, OH) to project spatially registered 3D holographic representations of the subject-specific aorta for intraoperative guidance and coupled with an electromagnetically (EM) tracked delivery system for intravascular navigation.

Impact of alterations in target vessel curvature on branch durability after endovascular repair of thoracoabdominal aortic aneurysms.

Objective: The aim of this study was to evaluate curvature and its effect on the durability of visceral and renal branches in patients undergoing endovascular repair of thoracoabdominal aortic aneurysms (TAAAs) with fenestrated/branched endovascular aneurysm repair (F/B-EVAR).

Methods: Quantitative branch vessel curvature assessment on branches arising from reinforced fenestrations was performed for 168 patients undergoing F/B-EVAR for type II and type III TAAAs. Preoperative and postoperative centerline coordinates were obtained using iNtuition (TeraRecon, Foster City, Calif) and exported into MATLAB (The MathWorks, Inc, Natick, Mass) based on thin-slice computed tomography imaging.

Cycle testing of the MagScrew total artificial heart external battery pack: update I.

MagScrew total artificial heart (TAH) external battery pack (EBP) cycle bench testing continued over a period of 18 months using two fresh Wilson Greatbatch lithium ion EBPs during continuous charge and discharge cycles under a simulated TAH system current requirement. The same electronic load developed for our initial testing was used to simulate the MagScrew current waveforms typically observed during nominal operation. The current load profiles for this test were modified from the ones previously described and applied to the EBP under test during a voltage-defined discharge cycle.

Automated vascular geometric analysis of aortic aneurysms.

An automated geometric analysis procedure uses volumetric computerized tomography scan data to produce a fully defined analytical model of the patient's arterial geometry with minimal user interaction. This model can be a powerful tool for surgery planning and stent design in addition to providing a basis for computational simulations.

Mathematical analysis of DICOM CT datasets: can endograft sizing be automated for complex anatomy?

Objectives: To validate the use of a novel mathematical algorithm applied to digital imaging and communication in medicine (DICOM) computed tomography (CT) data to automate the generation of complex endovascular graft planning.

Methods: An algorithm was developed enabling the creation of patient-specific mathematical model based upon DICOM CT data to allow for detailed efficient geometric analysis with repeatable results. This algorithm was applied to high resolution DICOM CT datasets of 15 patients, selected at random from 350 patients with aneurysms involving the visceral arteries.