Radiation-Free Thoracic Endovascular Aneurysm Repair with Fiberoptic and Electromagnetic Guidance: A Phantom Study

Malte Maria Sieren; Sonja Jäckle; Tim Eixmann; Hinnerk Schulz-Hildebrandt; Florian Matysiak; Mark Preuss; Verónica García-Vázquez; Erik Stahlberg; Markus Kleemann; Jörg Barkhausen; Jan Peter Goltz; Marco Horn

doi:10.1016/j.jvir.2021.12.025

Radiation-Free Thoracic Endovascular Aneurysm Repair with Fiberoptic and Electromagnetic Guidance: A Phantom Study

Malte Maria Sieren^*, Sonja Jäckle, Tim Eixmann, Hinnerk Schulz-Hildebrandt, Florian Matysiak, Mark Preuss, Verónica García-Vázquez, Erik Stahlberg, Markus Kleemann, Jörg Barkhausen, Jan Peter Goltz, Marco Horn

^*Corresponding author for this work

University of Kiel

10 Citations (Scopus)

Abstract

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 language	English
Journal	Journal of Vascular and Interventional Radiology
Volume	33
Issue number	4
Pages (from-to)	384-391.e7
ISSN	1051-0443
DOIs	https://doi.org/10.1016/j.jvir.2021.12.025
Publication status	Published - 04.2022

Funding

M.M.S. received support from the BMBF (Ministry for Education and Science, Germany; Grant number: 13GW0228A) for this work. S.J. received support from the BMBF (Ministry for Education and Science, Germany; Grant number: 13GW0228A) for this work. T.E.’s institution (Medical Laser Center Lübeck) received support from the BMBF (Ministry for Education and Science, Germany; Grant number: 13GW0228D) for this work. H.S.-H. received support from the BMBF (Ministry for Education and Science, Germany; Grant numbers: 13GW0228A and 82DZL001A2) for this work and is employed at the Institute of Biomedical Optics via the funded project: 82DZL001A2. F.M. received support from the BMBF (Ministry for Education and Science, Germany; Grant number: 13GW0228A) for this work. M.P. received support from the BMBF (Ministry for Education and Science, Germany; Grant number: 13GW0228A) for this work. V.G.-V.’s institution (Institute for Robotics and Cognitive Systems) received support from the BMBF (Ministry for Education and Science, Germany; Grant number: 13GW0228) for this work. V.G.-V. received support from the BMWi (Federal Ministry for Economic Affairs and Energy, Germany) (contract [3 months] regarding the preproject for the project Artificial Intelligence space for intelligent health systems [KI-SIGS]). V.G.-V. received travel support for the Santiago Aortic Meeting and Philips Medical Systems International B.V. E.S. received support from the BMBF (Ministry for Education and Science, Germany; Grant number: 13GW0228A) for this work. M.K. received support from the BMBF (Ministry for Education and Science, Germany; Grant number: 13GW0228A) for this work. J.B. received support from the BMBF (Ministry for Education and Science, Germany; Grant number: 13GW0228A) for this work. J.P.G. received support from the BMBF (Ministry for Education and Science, Germany; Grant number: 13GW0228A) for this work. M.H. received support from the BMBF (Ministry for Education and Science, Germany; Grant number: 13GW0228A) for this work.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 4 Quality Education
SDG 9 Industry, Innovation, and Infrastructure
SDG 11 Sustainable Cities and Communities
SDG 12 Responsible Consumption and Production
SDG 14 Life Below Water
SDG 15 Life on Land

Research Areas and Centers

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

DFG Research Classification Scheme

2.22-32 Medical Physics, Biomedical Technology
2.22-30 Radiology

Access to Document

10.1016/j.jvir.2021.12.025

Cite this

Sieren, M. M., Jäckle, S., Eixmann, T., Schulz-Hildebrandt, H., Matysiak, F., Preuss, M., García-Vázquez, V., Stahlberg, E., Kleemann, M., Barkhausen, J., Goltz, J. P., & Horn, M. (2022). Radiation-Free Thoracic Endovascular Aneurysm Repair with Fiberoptic and Electromagnetic Guidance: A Phantom Study. Journal of Vascular and Interventional Radiology, 33(4), 384-391.e7. https://doi.org/10.1016/j.jvir.2021.12.025

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title = "Radiation-Free Thoracic Endovascular Aneurysm Repair with Fiberoptic and Electromagnetic Guidance: A Phantom Study",

abstract = "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.",

author = "Sieren, \{Malte Maria\} and Sonja J{\"a}ckle and Tim Eixmann and Hinnerk Schulz-Hildebrandt and Florian Matysiak and Mark Preuss and Ver{\'o}nica Garc{\'i}a-V{\'a}zquez and Erik Stahlberg and Markus Kleemann and J{\"o}rg Barkhausen and Goltz, \{Jan Peter\} and Marco Horn",

note = "Publisher Copyright: {\textcopyright} 2022 SIR",

year = "2022",

month = apr,

doi = "10.1016/j.jvir.2021.12.025",

language = "English",

volume = "33",

pages = "384--391.e7",

journal = "Journal of Vascular and Interventional Radiology",

issn = "1051-0443",

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Sieren, MM , Jäckle, S, Eixmann, T, Schulz-Hildebrandt, H, Matysiak, F, Preuss, M, García-Vázquez, V, Stahlberg, E, Kleemann, M, Barkhausen, J, Goltz, JP & Horn, M 2022, 'Radiation-Free Thoracic Endovascular Aneurysm Repair with Fiberoptic and Electromagnetic Guidance: A Phantom Study', Journal of Vascular and Interventional Radiology, vol. 33, no. 4, pp. 384-391.e7. https://doi.org/10.1016/j.jvir.2021.12.025

TY - JOUR

T1 - Radiation-Free Thoracic Endovascular Aneurysm Repair with Fiberoptic and Electromagnetic Guidance

T2 - A Phantom Study

AU - Sieren, Malte Maria

AU - Jäckle, Sonja

AU - Eixmann, Tim

AU - Schulz-Hildebrandt, Hinnerk

AU - Matysiak, Florian

AU - Preuss, Mark

AU - García-Vázquez, Verónica

AU - Stahlberg, Erik

AU - Kleemann, Markus

AU - Barkhausen, Jörg

AU - Goltz, Jan Peter

AU - Horn, Marco

PY - 2022/4

Y1 - 2022/4

N2 - 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.

AB - 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.

UR - https://www.scopus.com/pages/publications/85126668510

U2 - 10.1016/j.jvir.2021.12.025

DO - 10.1016/j.jvir.2021.12.025

M3 - Journal articles

C2 - 34958860

AN - SCOPUS:85126668510

SN - 1051-0443

VL - 33

SP - 384-391.e7

JO - Journal of Vascular and Interventional Radiology

JF - Journal of Vascular and Interventional Radiology

IS - 4

ER -

Radiation-Free Thoracic Endovascular Aneurysm Repair with Fiberoptic and Electromagnetic Guidance: A Phantom Study

Abstract

Funding

UN SDGs

Research Areas and Centers

DFG Research Classification Scheme

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