Preoperative and intraoperative image processing for assisting endovascular stent grafting

Recent development in interventional radiology enables minimally invasive treatment of aortic aneurysm: endovascular stent grafting. We report image processing method in preoperative planning and intraoperative guidance for assisting endovascular stent grafting. In preoperative planning, it is necessary to design stent graft suitable for each clinical case. Thus we present shape measurement method of aneurysmal aorta for computer assisted design of stent graft. In stent grafting, fluoroscopic image is used as intraoperative image for visualizing lesion and interventional device. As fluoroscopic image is a two-dimensional (2D) image, a doctor has to imagine three-dimensional (3D) shape of aneurysmal aorta. For intraoperative guidance, it is useful to register preoperative 3D CT image with intraoperative 2D fluoroscopic images. We present intraoperative 3D/2D registration method for assisting endovascular stent grafting and show application result to clinical data.