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Apport de l'assistance par ordinateur lors de la pose d'endoprothèse aortique

Abstract : The development of endovascular aortic procedures is growing. These mini-invasive techniques allow a reduction of surgical trauma, usually important in conventional open surgery. The technical limitations of endovascular repair are pushed to special aortic localizations which were in the past decade indication for open repair. Success and efficiency of such procedures are based on the development and the implementation of decision-making tools. This work aims to improve endovascular procedures thanks to a better utilization of pre and intraoperative imaging. This approach is in the line with the framework of computer-assisted surgery whose concepts are applied to vascular surgery. The optimization of endograft deployment is considered in three steps. The first part is dedicated to preoperative imaging analysis and shows the limits of the current sizing tools. The accuracy of a new measurement criterion is assessed (outer curvature length). The second part deals with intraoperative imaging and shows the contribution of augmented reality in endovascular aortic repair. In the last part, image guided surgery on soft tissues is addressed, especially the arterial deformations occurring during endovascular procedures which disprove rigid registration in fusion imaging. The use of finite element simulation to deal with this issue is presented. We report an original approach based on a predictive model of deformations using finite element simulation with geometrical and anatomo-mechanical patient specific parameters extracted from the preoperative CT-scan.
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Submitted on : Thursday, October 15, 2015 - 12:26:06 PM
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  • HAL Id : tel-01215942, version 1

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Adrien Kaladji. Apport de l'assistance par ordinateur lors de la pose d'endoprothèse aortique. Cardiologie et système cardiovasculaire. Université Rennes 1, 2015. Français. ⟨NNT : 2015REN1B008⟩. ⟨tel-01215942⟩

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