Purpose: To evaluate the feasibility and accuracy of a radiation-free implantation of a thoracic aortic stent graft employing fiberoptic and electromagnetic tracking in an anthropomorphic phantom. Materials and Methods: An anthropomorphic phantom was manufactured based on computed tomography (CT) angiography data from a patient. An aortic stent graft application system was equipped with a fiber Bragg gratings and 3 electromagnetic sensors. The stent graft was navigated in the phantom by 3 interventionalists using the tracking data generated by both technologies. One implantation procedure was performed. The technical success of the procedure was evaluated using digital subtraction angiography and CT angiography (before and after the intervention). Tracking accuracy was determined at various anatomical landmarks based on separately acquired fluoroscopic images. The mean/maximum errors were measured for the stent graft application system and the tip/end of the stent graft. Results: The procedure resulted in technical success with a mean error below 3 mm for the entire application system and <2 mm for the position of the tip of the stent graft. Navigation/implantation and handling of the device were rated sufficiently accurate and on par with comparable, routinely used stent graft application systems. Conclusions: The study demonstrates successful stent graft implantation during a thoracic endovascular aortic repair procedure employing advanced guidance techniques and avoiding fluoroscopic imaging. This is an essential step in facilitating the implantation of stent grafts and reducing the health risks associated with ionizing radiation during endovascular procedures.

Original languageEnglish
JournalJournal of Vascular and Interventional Radiology
Issue number4
Pages (from-to)384-391.e7
Publication statusPublished - 04.2022

Research Areas and Centers

  • Academic Focus: Biomedical Engineering
  • Centers: Center for Artificial Intelligence Luebeck (ZKIL)

DFG Research Classification Scheme

  • 205-32 Medical Physics, Biomedical Engineering
  • 205-30 Radiology, Nuclear Medicine, Radiation Therapy and Radiobiology


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