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5 May 2004 Endovascular navigation based on real/virtual environments cooperation for computer-assisted TEAM procedures
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Transfemoral Endovascular Aneurysm Management, the less invasive treatment of Aortic Abdominal Aneurysms (AAA), is a highly specialized procedure, using advanced devices and requiring a high degree of clinical expertise. There is a great need for a navigation guidance system able to make this procedure safer and more precise. In this context of computer-assisted minimally invasive interventional procedures, we propose a new framework based on the cooperation between the real environment where the intervention takes place and a patient-specific virtual environment, which contains a virtual operating room including a C-arm model as well as the 3D preoperative patient data. This approach aims to deal with the problem of lack of knowledge about soft tissue behavior by better exploiting available information before and during the intervention through a cooperative approach. In order to assist the TEAM procedure in standard interventional conditions, we applied this framework to design a 3D navigation guidance system, which has been successfully used during three TEAM interventions in the operating room. Intra-operatively, anatomical feature-based 2D/3D registration between a single 2D fluoroscopic view, reproduced from the pose planned in the virtual environment, and the preoperative CT volume, is performed by means of a chamfer distance map. The 3D localization of the endovascular devices (sheath, guide wire, prosthesis) tracked either interactively or automatically on 2D sequences, is constrained to either the 3D vascular tree or a 3D device model. Moreover, we propose a first solution to take into account the tissue deformations during this particular intervention and to update the virtual environment with the intraoperative data.
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Cemil Goksu, Pascal Haigron, Oscar Acosta, and Antoine Lucas "Endovascular navigation based on real/virtual environments cooperation for computer-assisted TEAM procedures", Proc. SPIE 5367, Medical Imaging 2004: Visualization, Image-Guided Procedures, and Display, (5 May 2004);

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