Context Aware Catheter Navigation for Improved Stent Deployment (Creativity@Home Pilot)

心血管疾病是西方世界的主要死亡原因，其中血管疾病是主要致死因素。一种特殊的血管疾病是腹主动脉瘤(AAA)，它是导致死亡的主要原因之一。45-54岁男性AAA患病率为1.3%，75岁以上男性AAA患病率上升至12.5%。对于女性来说，尽管AAA在较年轻的年龄组中很少见，但在75岁以上的人中有5.2%。如果不治疗，主动脉瘤有破裂的风险，只有25%的病例活着送往医院，手术死亡率超过40%。血管内修复术比开放手术有几个优点：恢复时间更快，减少了对全身麻醉的需要，不需要剖腹手术，减少了出血，降低了勃起功能障碍的风险。在不适合开放手术的情况下，血管内修复手术很可能是一种经济有效的选择。该项目的目标是将实时传感、形状实例化与原位导管-组织相互作用的建模相结合，以便在动态主动约束下进行上下文感知的导管操作和支架部署。该项目是及时的，因为人口老龄化意味着主动脉瘤的患病率越来越高，对于这一患者群体来说，由于涉及的主要创伤，传统的开放手术不适合。从技术上讲，现在也是探索多模术中成像、传感和机器人技术用于微创治疗的最新发展的时候。机器人辅助背景感知导管导航的研究解决了血管内修复所面临的一些主要挑战，预期的研究结果将指导未来柔性机器人控制界面的设计，探索具有准物理行为和约束的模型更有利于对术中变化的快速适应。

Cardiovascular disease is the major cause of deaths in the Western world, of which vascular disease is a main contributing factor. One particular form of vascular disease is Abdominal Aortic Aneurysm (AAA), which is one of the leading causes of death. The prevalence of AAA is 1.3% in men 45-54 years of age, rising to 12.5% in men over the age of 75. For women, although AAA is rare in younger age groups, it is found in 5.2% of those over 75. Aortic aneurysms, if left untreated, risk rupture, with only 25% of cases reaching to hospital alive, with operative mortality exceeding 40%. Endovascular repair offers several advantages over open surgery: faster recovery time, reduced need for general anaesthesia, no laparotomy, less blood loss, and decreased risk of erectile dysfunction. Endovascular repair procedures are likely to be a cost-effective alternative in cases for which open surgery is unsuitable. The aim of the project is to integrate real-time sensing, shape instantiation combined with modelling of in situ catheter-tissue interaction for context-aware catheter manipulation and stent deployment under dynamic active constraints. The project is timely in that the ageing population implies increasing prevalence of aortic aneurysm and for this patient group, traditional open surgery is unsuitable due to the major trauma involved. Technically, it is also timely to explore the latest developments in multi-modal intra-operative imaging, sensing and robotics for minimally invasive therapy. The proposed research on context-aware, robotically assisted catheter navigation addresses some of the major challenges faced by endovascular repair and the expected research results will guide future designs of control interfaces for flexible robotics, and exploration of models with quasi-physical behaviour and constraints are more conducive to rapid adaptation to intra-operative variation.