搜索结果：neurointerventional

Photoacoustic imaging (PAI), by combining high optical contrast with ultrasonic resolution, offers a promising noninvasive approach for dynamic monitoring of cerebral vasculature. However, transcranial PAI still faces significant challenges due to strong attenuation of both optical and acoustic signals by the skull. In this study, we propose a multi-wavelength photoacoustic tomography system and method for intracranial pressure (ICP) assessment, enabling visualization of cross-sectional structures of the middle cerebral artery (MCA) through the human temporal bone. By utilizing multi-wavelength excitation in the near-infrared-I (NIR-I) window, quantitative maps of blood oxygen saturation ($\mathbf{sO_2}$) are reconstructed, and the relationship between oxygenation dynamics and ICP variations is established. Experimental results demonstrate that the proposed system can successfully capture dynamic $\mathbf{sO_2}$ fluctuations in the MCA despite skull attenuation, revealing its characteristic responses to ICP changes. This work provides a high-precision, noninvasive imaging tool for early stroke diagnosis, cerebral vascular function assessment, and neurointerventional guidance, highl

While we are making progress in overcoming infectious diseases and cancer; one of the major medical challenges of the mid-21st century will be the rising prevalence of stroke. Large vessels occlusions are especially debilitating, yet effective treatment (needed within hours to achieve best outcomes) remains limited due to geography. One solution for improving timely access to mechanical thrombectomy in geographically diverse populations is the deployment of robotic surgical systems. Artificial intelligence (AI) assistance may enable the upskilling of operators in this emerging therapeutic delivery approach. Our aim was to establish consensus frameworks for developing and validating AI-assisted robots for thrombectomy. Objectives included standardizing effectiveness metrics and defining reference testbeds across in silico, in vitro, ex vivo, and in vivo environments. To achieve this, we convened experts in neurointervention, robotics, data science, health economics, policy, statistics, and patient advocacy. Consensus was built through an incubator day, a Delphi process, and a final Position Statement. We identified that the four essential testbed environments each had distinct valid

Safe navigation of steerable and robotic catheters in the cerebral vasculature requires awareness of the catheters shape and pose. Currently, a significant perception burden is placed on interventionalists to mentally reconstruct and predict catheter motions from biplane fluoroscopy images. Efforts to track these catheters are limited to planar segmentation or bulky sensing instrumentation, which are incompatible with microcatheters used in neurointervention. In this work, a catheter is equipped with custom radiopaque markers arranged to enable simultaneous shape and pose estimation under biplane fluoroscopy. A design measure is proposed to guide the arrangement of these markers to minimize sensitivity to marker tracking uncertainty. This approach was deployed for microcatheters smaller than 2mm OD navigating phantom vasculature with shape tracking errors less than 1mm and catheter roll errors below 40 degrees. This work can enable steerable catheters to autonomously navigate under biplane imaging.

Rupture of intracranial aneurysms results in severe subarachnoidal hemorrhage, which is associated with high morbidity and mortality. Neurointerventional occlusion of the aneurysm through coiling has evolved to a therapeutical standard. The choice of the specific coil has an important influence on secondary regrowth requiring retreatment. Aneurysm occlusion was simulated either through virtual implantation of a preshaped 3D coil or with a porous media approach. In this study, we used a recently developed numerical approach to simulate aneurysm shapes in specific challenging aneurysm anatomies and correlated these with aneurysm recurrence 6 months after treatment. The simulation showed a great variety of coil shapes depending on the variability in possible microcatheter positions. Aneurysms with a later recurrence showed a tendency for more successful coiling attempts. Results revealed further trends suggesting lower simulated packing densities in aneurysms with reoccurrence. Simulated packing densities did not correlate with those calculated by conventional software, indicating the potential for our approach to offer additional predictive value. Our study, therefore, pioneers a com

Cerebrovascular disease is one of the major diseases facing the world today. Automatic segmentation of intracranial artery (IA) in digital subtraction angiography (DSA) sequences is an important step in the diagnosis of vascular related diseases and in guiding neurointerventional procedures. While, a single image can only show part of the IA within the contrast medium according to the imaging principle of DSA technology. Therefore, 2D DSA segmentation methods are unable to capture the complete IA information and treatment of cerebrovascular diseases. We propose A timing sequence image segmentation network with U-shape, called TSI-Net, which incorporates a bi-directional ConvGRU module (BCM) in the encoder. The network incorporates a bi-directional ConvGRU module (BCM) in the encoder, which can input variable-length DSA sequences, retain past and future information, segment them into 2D images. In addition, we introduce a sensitive detail branch (SDB) at the end for supervising fine vessels. Experimented on the DSA sequence dataset DIAS, the method performs significantly better than state-of-the-art networks in recent years. In particular, it achieves a Sen evaluation metric of 0.79

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