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An adaptive optimal viewing angle determination algorithm for TEVAR operation

Authors
  • Sun, Weiya1
  • Yang, Guanyu1, 2
  • Chen, Yang1, 2
  • Shu, Huazhong1, 2
  • 1 Southeast University, Nanjing, 210096, China , Nanjing (China)
  • 2 Centre de Recherche en Information BioMdicale Sino-Franais (CRIBs), Nanjing, China , Nanjing (China)
Type
Published Article
Journal
BMC Medical Imaging
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Oct 02, 2021
Volume
21
Issue
1
Identifiers
DOI: 10.1186/s12880-021-00676-3
Source
Springer Nature
Keywords
Disciplines
  • Research
License
Green

Abstract

BackgroundThe determination of the right x-ray angiography viewing angle is an important issue during the treatment of thoracic endovascular aortic repair (TEVAR). An inaccurate projection angle (manually determined today by the physicians according to their personal experience) may affect the placement of the stent and cause vascular occlusion or endoleak.MethodsBased on the acquisition of a computed tomography angiography (CTA) image before TEVAR, an adaptive optimization algorithm is proposed to determine the optimal viewing angle of the angiogram automatically. This optimal view aims at avoiding any overlapping between the left common carotid artery and the left subclavian artery. Moreover, the proposed optimal procedure exploits the patient-specific morphology to adaptively reduce the potential foreshortening effect.ResultsExperimental results conducted on thirty-five patients demonstrate that the optimal angiographic viewing angle based on the proposed method has no significant difference when compared with the expert practice (p = 0.0678).ConclusionWe propose a method that utilizes the CTA image acquired before TEVAR to automatically calculate the optimal C-arm angle. This method has the potential to assist surgeons during their interventional procedure by providing a shorter procedure time, less radiation exposure, and less contrast injection.

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