Magnetic Navigation for Thoracic Aortic Stent-graft Deployment Using Ultrasound Image Guidance

We propose a system for thoracic aortic stent-graft deployment that employs a magnetic tracking system (MTS) and intraoperative ultrasound (US). A preoperative plan is first performed using a general public utilities-accelerated cardiac modeling method to determine the target position of the stent-graft. During the surgery, an MTS is employed to track sensors embedded in the catheter, cannula, and the US probe, while a fiducial landmark based registration is used to map the patient's coordinate to the image coordinate. The surgical target is tracked in real time via a calibrated intraoperative US image. Under the guidance of the MTS integrated with the real-time US images, the stent-graft can be deployed to the target position without the use of ionizing radiation. This navigation approach was validated using both phantom and animal studies. In the phantom study, we demonstrate a US calibration accuracy of 1.5 ± 0.47 mm, and a deployment error of 1.4 ± 0.16 mm. In the animal study, we performed experiments on five porcine subjects and recorded fiducial, target, and deployment errors of 2.5 ± 0.32, 4.2 ± 0.78, and 2.43 ± 0.69 mm, respectively. These results demonstrate that delivery and deployment of thoracic stent-graft under MTS-guided navigation using US imaging is feasible and appropriate for clinical application.