Navigation and Visualisation in Endovascular Aortic Repair (Nav EVAR)

Project Description

Nav EVAR (Navigated Contrast-Agent and Radiation Sparing Endovascular Aortic Repair)

A fundamental problem of endovascular therapy of aortic aneurysms is the extraordinarily high radiation exposure - especially for the surgical team - caused by continuous X-ray imaging during the operation. In addition, this fluoroscopy requires the administration of high doses of nephrotoxic contrast medium to make the patient's blood vessels visible in the X-ray image. The BMBF-funded Nav EVAR project aims to solve these problems.

The Institute for Robotics and Cognitive Systems at the University of Lübeck (ROB Lübeck) is one of three technical partners in the project and has extensive expertise in the field of medical robotics and navigation. ROB Lübeck is involved in the subproject that deals with the following main points:

  • How can the position of an endovascular catheter be determined without X-ray imaging and contrast medium?

  • How can the surgeon understandably visualize the image and data acquired during the operation, together with the catheter position?

  • What accuracy can be achieved and can X-ray imaging be completely dispensed with?

There are approaches to all these questions which have been discussed and worked out jointly by the applicants and which are now to be developed into a demonstrator. The unique selling points of the project are in particular the use of state-of-the-art methods for the localisation of glass fibres with the aid of Bragg gratings in the fibre sheath and special augmented reality technology (Microsoft HoloLens). Robot-assisted 3D ultrasound is a pioneering technological alternative to X-ray imaging, which is also to be investigated in the project as a possible solution for the localization of the catheter.

The subproject's approach includes navigation, visualization, construction of endovascular hardware, intervention planning and modelling as well as validation and documentation. The research and realization of a combined Navigation solution (electromagnetic and glass fibre tracking), augmented reality visualization, patient localization by surface tracking, robot-assisted 3D ultrasound navigation as well as the validation of the accuracies of the individual approaches are the work steps.

The results will also be exploited jointly, through with different focal points. Commercial exploitation will take place in particular through the partners Fraunhofer-Institut für Bildgestützte Medizin MEVIS and the Medical Laser Center Lübeck and, in the medium term, a planned spin-off. The scientific exploitation (e.g. research into further areas of application, the integration of new technologies and the conception of follow-up projects) will be undertaken by the university partners ROB Lübeck, and the Department of Surgery and the Department of Radiology and Nuclear Medicine at University Hospital Schleswig-Holstein (UKSH).

Publications

Responsible

2018

Verónica García-Vázquez, Felix von Haxthausen, Sonja Jäckle, Christian Schumann, Ivo Kuhlemann, Juljan Bouchagiar, Anna-Catharina Höfer, Florian Matysiak, Gereon Hüttmann, Jan Peter Goltz, Markus Kleemann, Floris Ernst and Marco Horn, Navigation and visualisation with HoloLens in endovascular aortic repair (2018), in: Innovative Surgical Sciences
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Felix von Haxthausen, Floris Ernst, Ralf Bruder and Verónica García-Vázquez, Real-Time Streaming of 3D Ultrasound Data to HoloLens, in: 52nd Annual Conference of the German Society for Biomedical Engineering (BMT 2018), Aachen (Germany), 2018
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Felix von Haxthausen, Floris Ernst, Ralf Bruder and Verónica García-Vázquez, Streaming of 3D Data from Ultrasound Systems to Augmented Reality Glasses (HoloLens), in: Tagungsgband der 17. Jahrestagung der Deutschen Gesellschaft für Computer- und Roboterassistierte Chirurgie (CURAC), Leipzig (Germany), pages 2-3, Thomas Neumuth, Andreas Melzer, Claire Chalopin, 2018
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Sonja Jäckle, Felix von Haxthausen, Verónica García-Vázquez, Christian Schumann, Markus Kleemann, Floris Ernst and Nils Papenberg, Visuelle Unterstützung bei endovaskulären Eingriffen durch Darstellung einer virtuellen Angioskopie auf der HoloLens, in: 34. Jahrestagung der Deutschen Gesellschaft für Gefäßchirurgie und Gefäßmedizin (DGG), Bonn (Germany), 2018
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2017

Marco Horn, Jan Peter Goltz, Erik Stahlberg, Nils Papenberg, Floris Ernst and Markus Kleemann, Endovascular interventions proceeded under contrast agent and radiation sparing using navigation and imaging techniques for holographic visualisation, European Symposium on Vascular Biomaterials, Strasbourg (France), pages 173-180, 2017
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Ivo Kuhlemann, Markus Kleemann, Philipp Jauer, Achim Schweikard and Floris Ernst, Towards X-ray free endovascular interventions - Using HoloLens for on-line holographic visualization (2017), in: Healthcare Technology Letters, 4:5(184-187)
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2015

Marco Horn, Jan Nolde, Jan Peter Goltz, Jörg Barkhausen, Wolfgang Schade, Christian Waltermann, Jan Modersitzki, Janine Olesch, Nils Papenberg, Tobias Keck and Markus Kleemann, Ein Prototyp für die navigierte Implantation von Aortenstentprothesen zur Reduzierung der Kontrastmittel- und Strahlenbelastung: Das Nav-CARS-EVAR-Konzept (Navigated-Contrast-Agent and Radiation Sparing Endovascular Aortic Repair) (2015), in: Zentralblatt für Chirurgie, 140:05(493-499)
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