Finite-Element-Based Matching of Pre- and Intraoperative Data for Image-Guided Endovascular Aneurysm Repair

Endovascular repair of abdominal aortic aneurysms is a well-established technique throughout the medical and surgical communities. Although increasingly indicated, this technique does have some limitations. Because intervention is commonly performed under fluoroscopic control, 2-D visualization of the aneurysm requires the injection of a contrast agent. The projective nature of this imaging modality inevitably leads to topographic errors, and does not give information on arterial wall quality at the time of deployment. A specially adapted intraoperative navigation interface could increase deployment accuracy and reveal such information, which preoperative 3-D imaging might otherwise provide. One difficulty is the precise matching of preoperative data (images and models) and intraoperative observations affected by anatomical deformations due to tool–tissue interactions. Our proposed solution involves a finite-element-based preoperative simulation of tool–tissue interactions, its adaptive tuning regarding patient specific data, and the matching with intraoperative data. The biomechanical model was first tuned on a group of ten patients and assessed on a second group of eight patients.