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

血管内手术需要特殊的手术工具，通过血管系统插入和导航，以远程到达疾病部位。这种导航和治疗是在称为透视的视频x射线成像仪下进行的。尽管手术是在血管上进行的，但这张低功率x光片只显示了骨骼。化学剂染料可以暂时涂上血管，但大剂量使用时是有毒的。为了帮助外科医生导航，我们正在与西门子健康工程师一起开发一种增强可视化软件，该软件可以在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。这样可以减少造影剂的使用，缩短介入时间（从而减少辐射暴露），总体上改善手术效果。为了使血管结构变形而不使其可视化，我们将使用数学函数来计算受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，以达到最真实的行为。生物力学模拟作为一种验证工具已经在许多医学应用中使用。我们想要创新，把这个复杂的模拟结果带到一个实时的、反应性的应用程序中。这项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.