Real-time endovascular guidewire position simulation using shortest path algorithms.

Purpose: Treatment of vascular disease often involves endovascular interventions which use the vascular system for delivering treatment devices via a previously inserted guidewire to the diseased site. Previous studies show relative reproducibility of guidewire position after insertion, indicating that the guidewire position is constrained and could be represented by an energy minimization approach. Such representation would support the surgeon's decision process in guidewire selection.

Methods: In this paper, we determine the guidewire position using a k-level graph based on 3D vessel information. Guidewire properties are incorporated into the graph as edge weights given by the local bending energy related to the local bending angle. The optimal path through this weighted directed graph is determined using a shortest path algorithm. Volumetric data of two different internal carotid artery phantoms (Ø 3.5-4.6 mm) was acquired. Two guidewires (Ø 0.33 mm) of different material properties (stainless steel, plastic-coated steel core) were inserted into the phantoms.

Results: The average RMS distance between actual and simulated guidewire positions varies from 0.9 mm (plastic coated) to 1.3 mm (stainless steel); the computation time to determine the position was <2s.

Conclusions: The results indicate that the proposed technique yields reproducible and accurate guidewire positions within a short, clinically relevant time frame. These calculated positions may be useful in facilitating neurovascular interventions.