DRR-Guided Angulation: Leveraging Pre-operative CTA to Optimize Vessel Visualization in DSA-Assisted Thrombectomy
C. Cuţitei (TU Delft - Electrical Engineering, Mathematics and Computer Science)
X. Zhang – Mentor (TU Delft - Electrical Engineering, Mathematics and Computer Science)
J. Yang – Graduation committee member (TU Delft - Electrical Engineering, Mathematics and Computer Science)
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Abstract
This thesis project will be done in collaboration with ErasmusMC's Radiology Group. Frank te Nijenhuis, a former TU Delft Master's Student, current Phd candidate at Erasmus MC, created a proposal for the Perfusion DSA project. For some context, acute ischemic stroke is treated with mechanical thrombectomy. This procedure is performed under real time X-ray guidance. During the procedure, contrast fluid is enhanced while x-ray images are acquired in sequence. This allows for the creation of digital subtraction angiography images to visualize the contrast injection in real time.
This project addresses the clinical challenges of Mechanical Thrombectomy for Acute Ischemic Stroke by optimizing the intraoperative imaging workflow. Currently, interventionists must rely on a trial-and-error process during Digital Subtraction Angiography to find the best imaging angle, which frequently leads to vessel foreshortening or overshadowing while increasing the patient's exposure to radiation and nephrotoxic contrast agents. To streamline this procedure, the project proposes a DRR-Guided Angulation approach that leverages pre-operative CTA scans to generate Digitally Reconstructed Radiographs. This method allows for the identification of optimal C-arm orientations before the procedure begins, ultimately aiming to reduce surgical time and improve the visualization of complex 3D vascular anatomy.