Image-guided treatment planning for neuro-interventions

图像引导的神经干预治疗计划

• 批准号: 7099449
• 负责人: KENNETH R HOFFMANN
• 金额: $ 29.56万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-20 至 2008-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7099449
• 关键词: bioimaging /biomedical imaging; blood vessel prosthesis; carotid artery; cerebroangiography; cerebrovascular imaging /visualization; cerebrovascular surgery; clinical research; diagnostic catheterization; human data; image guided surgery /therapy; information systems; intraluminal angioplasty; nervous system disorder therapy; technology /technique development; bioimaging /biomedical imaging; blood vessel prosthesis; carotid artery; cerebroangiography; cerebrovascular imaging /visualization; cerebrovascular surgery; clinical research; diagnostic catheterization; human data; image guided surgery /therapy; information systems; intraluminal angioplasty; nervous system disorder therapy; technology /technique development

DESCRIPTION (provided by applicant): Endovascular neurologic interventions are increasing in frequency and complexity. Devices are being placed above the Circle of Willis. Currently, interventionalists are judging accessibility via the proximal vessels using only subjective estimations from 2D angiograms. As a result, complication rates during procedures are as high as 10%. Calculation of the tortuosity of vessels can be performed from data extracted from computed tomography angiography (CTA), magnetic resonance angiography (MRA), and biplane or rotational angiograms, but the intervention a list also needs feedback of catheter position relative to the vasculature during the procedure. In addition, models are needed to estimate patient risk prior to placement. The goal of the proposed research is safer neuro-endovascular procedures, achieved by developing a system that can provide the interventionalist with information on vessel tortuosity, accessibility, device position, and potential complications during the procedure prior to and during device placement. Therefore, we propose to determine the hitherto unavailable quantities of curvature of, tortuosity of, and accessibility via the carotid, vertebral, and basilar arteries. Moreover, we will develop innovative, new techniques for estimating position and orientation of catheters, angioplasty balloons, and stents relative to vessel walls (proximity) and fusing this information with the vascular information for use during the procedure. With this information, we will develop models relating curvature, tortuosity, and proximity to complications so that the interventionalist can make more informed decisions regarding patient treatment involving interventional devices prior to and during attempts at placement, and thereby, reduce patient mortality and morbidity. With curvature and tortuosity available during interventional neurovascular procedures, coupled with relative 3D catheter positions and calculated probabilities of complications, we expect to improve access decisions as well as interventional device decisions. The impact of the proposed research is expected to lead to a substantial reduction of mortality and morbidity associated with neurovascular procedures.

描述（由申请人提供）： 血管内神经系统干预的频率和复杂性正在增加。设备被放置在威利斯圆上的上方。当前，介入主义者正在仅使用2D血管造影的主观估计来通过近端血管来判断可及性。结果，过程中的并发症发生率高达10％。可以根据从计算机断层造影血管造影（CTA），磁共振血管造影（MRA）和双层或旋转血管造影的数据中提取的数据来计算血管的曲折性，但是在该手术过程中，列表还需要相对于脉管系统的导管位置的反馈。此外，需要模型才能在放置之前估算患者的风险。拟议的研究的目的是通过开发一个可以为介入主义者提供有关船舶曲折，可及性，设备位置和潜在并发症的系统来实现的更安全的神经内血管手术。因此，我们建议通过颈动脉，椎骨和基底动脉来确定迄今无法获得的曲率，曲折和可及性。此外，我们将开发创新的，新技术，用于估计导管，血管成形术气球的位置和方向，以及相对于血管壁（接近度）的支架，并将这些信息与该信息进行融合，以便在手术过程中使用。有了这些信息，我们将开发模型，将曲率，曲折性和与并发症的接近性相关联，以便介入主义者可以在放置之前和尝试期间就涉及干预设备的患者治疗做出更明智的决定，从而降低患者死亡率和发病率。在介入性神经血管手术过程中可用的曲率和曲折性，再加上相对3D导管位置和并发症的计算概率，我们希望改善访问决策以及介入设备的决策。拟议的研究的影响预计会导致与神经血管手术相关的死亡率和发病率大大降低。