Patient specific biomechanical modeling of abdominal aortic aneurysm to improve aortic endovascular repair

血管内手术需要插入特殊的手术工具并通过血管系统导航，以远程到达疾病部位。该导航和治疗在称为荧光透视的视频X射线成像仪下进行。尽管手术是在血管上进行的，但这种低功率X射线只能显示骨骼。化学剂染料可使容器瞬间着色，但用量大时有毒。为了帮助外科医生导航，我们正在与Siemens Healthineers合作开发一种增强可视化软件，该软件可在荧光透视图像上显示患者的血管结构，并通过血管内工具的变形力调整其形状。这可以减少造影剂的使用，减少介入时间（从而减少辐射暴露），并普遍改善手术结果。为了在不可视化的情况下使血管结构变形，我们将使用数学函数来计算受到血管内工具影响时的血管形状。该功能将基于在大型介入图像数据库上进行的生物力学计算机模拟。整个腹部区域的组织将被简化和建模，以实现最真实的行为。生物力学模拟已被用于许多医疗应用作为验证工具。我们希望进行创新，将这种复杂的仿真结果带到实时和反应式应用中。这一技术创新将大大提高图像融合辅助软件的性能和可靠性，并在医疗实践中树立新的标准。

Endovascular surgery requires of special surgical tools inserted and navigated through the vascular system to reach the site of a disease remotely. This navigation and treatment are perform under video X-Ray imager called fluoroscopy. This low-power X-Ray reveals only the bones, even though the surgery is performed on the vessels. Chemical agent dye can paint momentarily the vessel, but this agent is toxic when used in high dosage. In order to help the surgeon navigate its way, we are developing with Siemens Healthineers an enhance visualization software that displays on the fluoroscopic image the vascular structures of the patient and adapts its shape by the deformation force of the endovascular tools. This can reduce the use of contrast agent, reduce the intervention time (thus reducing radiation exposure) and generally improve the surgical outcomes.To deform the vascular structure without its visualization, we will use a mathematical function to compute the vessel shape when subjected to endovascular tools influence. This function will be based on biomechanical computer simulations performed on a large database of interventional images. Tissues of the entire abdominal region will be simplified and modeled to achieve the most realistic behaviour. Biomechanical simulations have been used in numerous medical applications as a validation tool. We want to innovate and bring this complex simulation result to a live and reactive application. This technological innovation will improve substantially the performances and reliability of image fusion assisting software and set a new standard in medical care practices.