Endovascular Stenting of Aortic Aneurysms In medical collaboration with: St. Olavs Hospital (NTNU, Norway) Klinikum München-Pasing Klinikum rechts der Isar Klinikum Innenstadt In academic collaboration with: SINTEF Medical Imaging Scientific Director: Nassir Navab Contact Person(s): Stefanie Demirci

Keywords: Computer-Aided Surgery, Past Projects

Abstract

Endovascular stenting is a minimally invasive treatment technique for aortic aneurysms or dissections. Thereby, a certain aortic prosthesis (stent graft) is placed inside the aortic aneurysm in order to prevent a life-threatening rupture of the aortic wall. Prior to the intervention, a computed tomography angiography (CTA) is acquired on which the surgical staff can measure the parameter of the desired stent graft and finalize the intervention workflow. The entire interventional catheter navigation is done under 2D angiography imaging where the physician is missing the important 3D information. The purpose of our project is two-fold:
1. In the planning phase, a modified graph cuts algorithm automatically segments the aorta and aneurysm, so the surgical staff can choose an appropriate type of stent to match the segmented location, length, and diameter of the aneurysm and aorta. By visualizing the defined stent graft next to the three-dimensionally reconstructed aneurysm, mismeasurements can be detected in an early stage. Our main goal is the creation of an interactive simulation system that predicts the behaviour of the aortic wall and the movement of the implanted stent graft.
2. During implantation of the stent graft, after an intensity based registration of CTA and angiography data, the current navigation can be visualized in the 3D CT data set at any time. This includes solutions for electro-magnetic tracking of catheters as well as guide wires and stent grafts. Eventually, Our main goal is the creation of solutions that enable the surgeon to enhance the accuracy of the navigation and positioning, along with a minimum use of angiography, leading to less radiation exposure and less contrast agent injection.

Pictures

Figure 1:

Figure 2: Volume Rendering of CTA after stent implantation in decending aorta

Figure 3: Disocclusion for Medical Image Registration: original image(top left), Stent-editing (top right), spline interpolation (lower left), digital inpainintg (lower right) of the occlusion.

Depth Recovery from Single View Simulated X-ray Images

Publications

2018
	D. Stoyanov, R. Taylor, S. Balocco, R. Sznitman, A. Martel, L. Maier-Hein, L. Duong, G. Zahnd, S. Demirci, S. Albarqouni, J. Lee, S. Moriconi, V. Cheplygina, D. Mateus, E. Trucco, E. Granger, P. Jannin Intravascular Imaging and Computer Assisted Stenting and Large-Scale Annotation of Biomedical Data and Expert Label Synthesis MICCAI 2018 Workshops (bib)
2017
	J. Cardoso, T. Arbel, J. Lee, V. Cheplygina, S. Balocco, D. Mateus, G. Zahnd, L. Maier-Hein, S. Demirci, E. Granger, L. Duong, M. A. Carbonneau, S. Albarqouni, G. Carneiro Intravascular imaging and computer assisted stenting, and large-scale annotation of biomedical data and expert label synthesis MICCAI 2017 Workshops (bib)
	S. Balocco, M. Zuluaga, G. Zahnd, S. L. Lee, S. Demirci Computing and visualization for intravascular imaging and computer-assisted stenting ELSEVIER Academic Press (bib)
	S. Matl, R. Brosig, M. Baust, N. Navab, S. Demirci Vascular Image Registration Techniques: A Living Review Medical Image Analysis, Volume 35, pp. 1-7, 2017 (bib)
2016
	S. Albarqouni, U. Konrad, L. Wang, N. Navab, S. Demirci Single-View X-Ray Depth Recovery: Towards a Novel Concept for Image-Guided Interventions International Journal of Computer Assisted Radiology and Surgery (IJCARS), 2016, June 2016, Volume 11, Issue 6, pp 873-880. (bib)
2015
	S. Virga, V. Dogeanu, P. Fallavollita, R. Ghotbi, N. Navab, S. Demirci Optimal C-arm Positioning for Aortic Interventions Bildverarbeitung fuer die Medizin (BVM 2015), Luebeck, Germany, March 2015 (bib)
	S.-L. Lee, S. Balocco, C. Gatta, S. Demirci, G. A. Tangen Editorial of the special issue STENT Computerized Medical Imaging and Graphics, Special Issue STENT, In Press, 2015 (bib)
	D. Volpi, M. H. Sarhan, R. Ghotbi, N. Navab, D. Mateus, S. Demirci Online Tracking of Interventional Devices for Endovascular Aortic Repair International Journal of Computer Assisted Radiology and Surgery, June 2015, Volume 10, Issue 6, pp 773-781 (bib)
2013
	S.-L. Lee, S. Demirci, P. Radeva, G. Unal Editorial Note Computerized Medical Imaging and Graphics, vol. 38, pages 69-69, 2014 (bib)
	S. Demirci, F. Manstad-Hulaas, N. Navab Interventional 2D-3D Registration in the Presence of Occlusion XIII Mediterranean Conference on Medical and Biological Engineering and Computing 2013, IFMBE Proceedings Volume 41, 2014, pp 277-280. (bib)
	S. Demirci, M. Baust, O. Kutter, F. Manstad-Hulaas, H-H. Eckstein, N. Navab Disocclusion-based 2D-3D Registration for Aortic Interventions Computers in Biology and Medicine, Volume 43, Issue 4, 1 May 2013, Pages 312-322 (bib)
2011
	S. Demirci, A. Bigdelou, L. Wang, C. Wachinger, M. Baust, R. Tibrewal, R. Ghotbi, H-H. Eckstein, N. Navab 3D Stent Recovery from One X-ray Projection 14th International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI), Toronto (CA), September 18-22, 2011 (bib)
2010
	F. Manstad-Hulaas, G. A. Tangen, S. Demirci, M. Pfister, S. Lydersen, T. A. Nagelhus Hernes Endovascular Image-Guided Navigation - Validation of Two Volume-Volume Registration Algorithms Minimally Invasive Therapy & Allied Technologies 20(5), pp. 282 - 289, 2011 (bib)
2009
	S. Demirci, G. Lejeune, N. Navab Hybrid Deformable Model for Aneurysm Segmentation Biomedical Imaging: From Nano to Macro, 2009. ISBI '09. IEEE International Symposium on, pp. 33-36, 2009. (bib)
	S. Demirci, F. Manstad-Hulaas, N. Navab Extracting a Purely Non-Rigid Deformation Field of a Single Structure Proceedings of Bildverarbeitung fuer die Medizin (BVM 2009), Heidelberg, Germany, March 2009 (bib)
	S. Demirci, F. Manstad-Hulaas, N. Navab Quantification of Abdominal Aortic Deformation after EVAR Proc. SPIE 7261, Medical Imaging 2009: Visualization, Image-Guided Procedures, and Modeling, 72611U, February 2009 (bib)
2008
	S. Demirci, O. Kutter, F. Manstad-Hulaas, R. Bauernschmitt, N. Navab Advanced 2D-3D Registration for Endovascular Aortic Interventions: Addressing Dissimilarity in Images Proc. SPIE 6918, Medical Imaging 2008: Visualization, Image-guided Procedures, and Modeling, 69182S, February 2008 (bib)
2007
	O. Kutter, S. Kettner, E.U. Braun, N. Navab, R. Lange, R. Bauernschmitt Towards an Integrated Planning and Navigation System for Aortic Stent-Graft Placement Proc. of Computer Assisted Radiology and Surgery (CARS), Berlin, Germany, June 2007. (bib)
2006
	M. Feuerstein, K. Filippatos, O. Kutter, E.U. Schirmbeck, R. Bauernschmitt, N. Navab A Novel Segmentation and Navigation Tool for Endovascular Stenting of Aortic Aneurysms International Journal of Computer Assisted Radiology and Surgery, 2006; Vol. 1 Suppl. 1, page 280 - 282. The original publication is available online at www.springerlink.com (bib)
2005
	R. Bauernschmitt, M. Feuerstein, E.U. Schirmbeck, N. Augustin, S.M. Wildhirt, R. Lange Improvement of Endovascular Stent Grafting by Augmented Reality Biomedizinische Technik (BMT 2005), Volume 50, Supplementary vol. 1, Part 2, pp. 1262 - 1263, Nuremberg, Germany, September 2005 (bib)
2004
	R. Bauernschmitt, E.U. Schirmbeck, M. Groher, P. Keitler, M. Bauer, H. Najafi, G. Klinker, R. Lange Navigierte Platzierung endovaskulärer Aortenstents Z Kardiologie 2004 93 S3: 116 (bib)

Team

Contact Person(s)

Dr. Stefanie Demirci

Working Group

Dr. Shadi Albarqouni

Alumni

Dr. Ali Bigdelou

Dr. Kanishka Sharma

Dr. Marco Feuerstein

Dr. Martin Groher

Dr. Oliver Kutter

Dr. Peter Keitler

Location

Technische Universität München Institut für Informatik / I16 Boltzmannstr. 3 85748 Garching bei München Tel.: +49 89 289-17058 Fax: +49 89 289-17059

Visit our lab at Garching.

Ludwig-Maximilians-Universität München Chirurgische Klinik und Poliklinik - Innenstadt, AG CAS Nussbaumstr. 20 80336 München Room: C2.06 Tel.: +49 89 5160-3615 Tel.: +49 89 5160-3635 Fax: +49 89 5160-3630

Visit our lab at Klinikum Innenstadt.

Klinikum rechts der Isar der Technischen Universitüt München Ismaninger Str. 22 81675 München IFL Lab - Room: 01.3a-c Tel.: +49 89 4140-6457 Fax: +49 89 4140-6458

Visit our lab at Klinikum rechts der Isar.



internal project page

Please contact Stefanie Demirci for available student projects within this research project.