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

心血管疾病是西方世界死亡的主要原因，其中血管疾病是主要的促成因素。一种特殊形式的血管疾病是腹主动脉瘤（AAA），这是死亡的主要原因之一。AAA的患病率在45-54岁男性中为1.3%，在75岁以上男性中上升至12.5%。对于女性来说，尽管AAA在年轻群体中很少见，但在75岁以上的女性中却有5.2%患有AAA。主动脉瘤如果不及时治疗，有破裂的危险，只有25%的病例能活着到达医院，手术死亡率超过40%。与开放手术相比，血管内修复术有几个优点：恢复时间更快，减少全身麻醉的需要，无需剖腹手术，失血量更少，勃起功能障碍的风险降低。对于不适合开放手术的病例，血管内修复术可能是一种具有成本效益的替代方案。该项目的目的是将实时传感、形状实例化与原位导管-组织相互作用的建模相结合，以在动态主动约束下进行情境感知导管操作和支架展开。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增加，对于这一患者群体，由于涉及重大创伤，传统的开放手术不适合。从技术上讲，探索微创治疗的多模式术中成像、传感和机器人技术的最新发展也是及时的。拟议的上下文感知，机器人辅助导管导航的研究解决了腔内修复术所面临的一些主要挑战，预期的研究结果将指导未来的设计控制接口的灵活机器人，和探索模型的准物理行为和约束更有利于快速适应术中的变化。

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.