Standard and fenestrated endograft sizing in EVAR planning: Description and validation of a semi-automated 3D software.
An abdominal aortic aneurysm (AAA) is a pathological dilation of the abdominal aorta that may lead to a rupture with fatal consequences. Endovascular aneurysm repair (EVAR) is a minimally invasive surgical procedure consisting of the deployment and fixation of a stent-graft that isolates the damaged vessel wall from blood circulation. The technique requires adequate endovascular device sizing, which may be performed by vascular analysis and quantification on Computerized Tomography Angiography (CTA) scans. This paper presents a novel 3D CTA image-based software for AAA inspection and EVAR sizing, eVida Vascular, which allows fast and accurate 3D endograft sizing for standard and fenestrated endografts. We provide a description of the system and its innovations, including the underlying vascular image analysis and visualization technology, functional modules and user interaction. Furthermore, an experimental validation of the tool is described, assessing the degree of agreement with a commercial, clinically validated software, when comparing measurements obtained for standard endograft sizing in a group of 14 patients.
Vicomtech-IK4 Foundation, Donostia/San Sebastián, Spain(1); Biodonostia Health Research Institute, Donostia/San Sebastián, Spain; Computational Intelligence Group, Computer Engineering Faculty, University of the Basque Country, Donostia/San Sebastián, Spain. Electronic address: imacia@vicomtech.org.
Iván
I
Macía
Department of Radiology, Donostia University Hospital, Donostia/San Sebastián, Spain; Biodonostia Health Research Institute, Donostia/San Sebastián, Spain.
Mariano
M
de Blas
Vicomtech-IK4 Foundation, Donostia/San Sebastián, Spain(1); Biodonostia Health Research Institute, Donostia/San Sebastián, Spain.
Jon Haitz
JH
Legarreta
Vicomtech-IK4 Foundation, Donostia/San Sebastián, Spain(1); Biodonostia Health Research Institute, Donostia/San Sebastián, Spain.
Luis
L
Kabongo
eMedica S.L., Zamudio, Spain.
Óscar
Ó
Hernández
Department of Vascular Surgery, Donostia University Hospital, Donostia/San Sebastián, Spain; Biodonostia Health Research Institute, Donostia/San Sebastián, Spain.
José María
JM
Egaña
Department of Clinical Epidemiology, Donostia University Hospital, Donostia/San Sebastián, Spain; Biodonostia Health Research Institute, Donostia/San Sebastián, Spain.
José Ignacio
JI
Emparanza
Department of Vascular Surgery, Donostia University Hospital, Donostia/San Sebastián, Spain.
Ainhoa
A
García-Familiar
Computational Intelligence Group, Computer Engineering Faculty, University of the Basque Country, Donostia/San Sebastián, Spain.
Manuel
M
Graña
D017544:Aortic Aneurysm, Abdominal / Q000628:therapy; D001807:Blood Vessel Prosthesis; D057510:Endovascular Procedures; D006801:Humans; D021621:Imaging, Three-Dimensional; D012984:Software; D015607:Stents
Abdominal aortic aneurysm; Computerized Tomography Angiography; Endograft; Endovascular aneurysm repair; Image quantification; Image segmentation; Software; Stent; Surgical planning; Vascular image analysis