Clinical application of three-dimensional navigation technology in endovascular treatment of proximal renal abdominal aortic aneurysm

Objective: To explore the application value of intelligent mobile 3D navigation technology in hybrid operating room in endovascular treatment of proximal renal abdominal aortic aneurysm. Methods: The clinical data of 7 patients with proximal renal abdominal aortic aneurysm treated in the hybrid operating room from February 2016 to June 2018 were retrospectively analyzed. During the operation, after 3D-DSA (digital subtraction angiography three-dimensional imaging) has been done, 3D reconstruction image and 2D (2D imaging) perspective image were fused, renal artery and other important branch blood vessels were marked in the process of operation. In addition, the intraoperative 3D navigation fusion images in different stages and positions were automatically modified. According to the requirements of the operation, the background density of blood vessels and bones in the fusion image should be improved, so the vascular visibility in the superimposed image were improved, and the stent release should be guided accurately. Therefore, the purpose of accurate navigation in the endovascular treatment is achieved. Results: The guidewire and catheter were successfully selected into the target vessel by the 3D navigation. Stents were all released accurately, and angiography indicated the aneurysms were successfully isolated without endoleak. Conclusions: The openings of renal arteries and other vessel branches can be accurately marked by the three-dimensional navigation technology in the hybrid operating room, It is convenient to select target blood vessel during the operation. This technology plays an important role in guiding the endovascular treatment of proximal renal abdominal aortic aneurysm. Key words: Hybrid operating room; Three-dimensional navigation; Image fusion; Proximal renal abdominal aortic aneurysm; Endovascular aneurysm repair