搜索结果：Vascular and endovascular surgery

Real-time visual feedback from catheterization analysis is crucial for enhancing surgical safety and efficiency during endovascular interventions. However, existing datasets are often limited to specific tasks, small scale, and lack the comprehensive annotations necessary for broader endovascular intervention understanding. To tackle these limitations, we introduce CathAction, a large-scale dataset for catheterization understanding. Our CathAction dataset encompasses approximately 500,000 annotated frames for catheterization action understanding and collision detection, and 25,000 ground truth masks for catheter and guidewire segmentation. For each task, we benchmark recent related works in the field. We further discuss the challenges of endovascular intentions compared to traditional computer vision tasks and point out open research questions. We hope that CathAction will facilitate the development of endovascular intervention understanding methods that can be applied to real-world applications. The dataset is available at https://airvlab.github.io/cathaction/.

Cardiovascular diseases account for around 17.9 million deaths per year globally, the treatment of which is challenging considering the confined space and complex topology of the vascular network and high risks during operations. Robots, although promising, still face the dilemma of possessing versatility or maneuverability after decades of development. Inspired by nematodes, the parasites living, feeding, and moving in the human body's vascular system, this work develops a transformable slender magnetic microrobot. Based on the experiments and analyses, we optimize the fabrication and geometry of the robot and finally create a slender prototype with an aspect ratio larger than 100 (smaller than 200 microns in diameter and longer than 20 mm in length), which possesses uniformly distributed magnetic beads on the body of an ultrathin polymer string and a big bead on the head. This prototype shows great flexibility (largest curvature 0.904 mm-1) and locomotion capability (the maximum speed: 125 mm/s). Moreover, the nematode-inspired robot can pass through sharp turns with a radius of 0.84 mm and holes distributed in three-dimensional (3D) space. We also display the potential applicati

Endovascular interventions are a life-saving treatment for many diseases, yet suffer from drawbacks such as radiation exposure and potential scarcity of proficient physicians. Robotic assistance during these interventions could be a promising support towards these problems. Research focusing on autonomous endovascular interventions utilizing artificial intelligence-based methodologies is gaining popularity. However, variability in assessment environments hinders the ability to compare and contrast the efficacy of different approaches, primarily due to each study employing a unique evaluation framework. In this study, we present deep reinforcement learning-based autonomous endovascular device navigation on three distinct digital benchmark interventions: BasicWireNav, ArchVariety, and DualDeviceNav. The benchmark interventions were implemented with our modular simulation framework stEVE (simulated EndoVascular Environment). Autonomous controllers were trained solely in simulation and evaluated in simulation and on physical test benches with camera and fluoroscopy feedback. Autonomous control for BasicWireNav and ArchVariety reached high success rates and was successfully transferred

The diffusion of minimally invasive, endovascular interventions motivates the development of visualization methods for complex vascular networks. We propose a planar representation of blood vessel trees which preserves the properties that are most relevant to catheter navigation: topology, length and curvature. Taking as input a three-dimensional digital angiography, our algorithm produces a faithful two-dimensional map of the patient's vessels within a few seconds. To this end, we propose optimized implementations of standard morphological filters and a new recursive embedding algorithm that preserves the global orientation of the vascular network. We showcase our method on peroperative images of the brain, pelvic and knee artery networks. On the clinical side, our method simplifies the choice of devices prior to and during the intervention. This lowers the risk of failure during navigation or device deployment and may help to reduce the gap between expert and common intervention centers. From a research perspective, our method simulates the cadaveric display of artery trees from anatomical dissections. This opens the door to large population studies on the branching patterns and

Endovascular procedures have revolutionized vascular disease treatment, yet their manual execution is challenged by the demands for high precision, operator fatigue, and radiation exposure. Robotic systems have emerged as transformative solutions to mitigate these inherent limitations. A pivotal moment has arrived, where a confluence of pressing clinical needs and breakthroughs in AI creates an opportunity for a paradigm shift toward Embodied Intelligence (EI), enabling robots to navigate complex vascular networks and adapt to dynamic physiological conditions. Data-driven approaches, leveraging advanced computer vision, medical image analysis, and machine learning, drive this evolution by enabling real-time vessel segmentation, device tracking, and anatomical landmark detection. Reinforcement learning and imitation learning further enhance navigation strategies and replicate expert techniques. This review systematically analyzes the integration of EI into endovascular robotics, identifying profound systemic challenges such as the heterogeneity in validation standards and the gap between human mimicry and machine-native capabilities. Based on this analysis, a conceptual roadmap is p

This research reports VascularPilot3D, the first 3D fully autonomous endovascular robot navigation system. As an exploration toward autonomous guidewire navigation, VascularPilot3D is developed as a complete navigation system based on intra-operative imaging systems (fluoroscopic X-ray in this study) and typical endovascular robots. VascularPilot3D adopts previously researched fast 3D-2D vessel registration algorithms and guidewire segmentation methods as its perception modules. We additionally propose three modules: a topology-constrained 2D-3D instrument end-point lifting method, a tree-based fast path planning algorithm, and a prior-free endovascular navigation strategy. VascularPilot3D is compatible with most mainstream endovascular robots. Ex-vivo experiments validate that VascularPilot3D achieves 100% success rate among 25 trials. It reduces the human surgeon's overall control loops by 18.38%. VascularPilot3D is promising for general clinical autonomous endovascular navigations.

Aims: To develop an in-silico model of the aorta and its spinal cord-supplying branches, and to characterise haemodynamic changes following aortic aneurysm (AA) repair with such a model. The work is motivated by the risk of spinal cord ischaemia (SCI) and paraplegia, serious complications that can arise from disruption of spinal cord perfusion during AA surgery. Methods: SimVascular was used to retrospectively create models of a 76 year old female patient's aorta pre- and post- uncomplicated endovascular AA repair. The full extent of the aorta and its branches, including vessels supplying the spinal cord, was segmented. Pulsatile flow simulations were conducted under the assumption of rigid vessel walls, with patient-specific inlet and three-element Windkessel models for the outlet boundary conditions on the SimVascular Gateway Cluster. Results: Postoperatively, segmental artery flow to the spinal cord decreased by 51.86% due to exclusion of lumbar and posterior intercostal arteries by the stent graft. Spinal cord-supplying arteries showed increased TAWSS (+5.2%) and reduced RRT and ECAP, with minimal change in OSI. Consistent with redistribution away from the spinal territory, mod

Robot-assisted endovascular intervention offers a safe and effective solution for remote catheter manipulation, reducing radiation exposure while enabling precise navigation. Reinforcement learning (RL) has recently emerged as a promising approach for autonomous catheter steering; however, conventional methods suffer from sparse reward design and reliance on static vascular models, limiting their sample efficiency and generalization to intraoperative variations. To overcome these challenges, this paper introduces a sample-efficient RL framework with online expert correction for autonomous catheter steering in endovascular bifurcation navigation. The proposed framework integrates three key components: (1) A segmentation-based pose estimation module for accurate real-time state feedback, (2) A fuzzy controller for bifurcation-aware orientation adjustment, and (3) A structured reward generator incorporating expert priors to guide policy learning. By leveraging online expert correction, the framework reduces exploration inefficiency and enhances policy robustness in complex vascular structures. Experimental validation on a robotic platform using a transparent vascular phantom demonstra

Cerebral blood flow regulation is critical for brain function, and its disruption is implicated in various neurological disorders. Many existing models do not fully capture the complex, multiscale interactions among neuronal activity, astrocytic signaling, and vascular dynamics--especially in key brainstem regions. In this work, we present a 3D-1D-0D multiscale computational framework for modeling the neuro-glial-vascular unit (NGVU) in the dorsal vagal complex (DVC). Our approach integrates a quadripartite synapse model--which represents the interplay among excitatory and inhibitory neurons, astrocytes, and vascular smooth muscle cells--with a hierarchical description of vascular dynamics that couples a three-dimensional microcirculatory network with a one-dimensional macrocirculatory representation and a zero-dimensional synaptic component. By linking neuronal spiking, astrocytic calcium and gliotransmitter signaling, and vascular tone regulation, our model reproduces key features of functional hyperemia and elucidates the feedback loops that help maintain cerebral blood flow. Simulation results demonstrate that neurotransmitter release triggers astrocytic responses that modulate

In endovascular surgery, the precise identification of catheters and guidewires in X-ray images is essential for reducing intervention risks. However, accurately segmenting catheter and guidewire structures is challenging due to the limited availability of labeled data. Foundation models offer a promising solution by enabling the collection of similar domain data to train models whose weights can be fine-tuned for downstream tasks. Nonetheless, large-scale data collection for training is constrained by the necessity of maintaining patient privacy. This paper proposes a new method to train a foundation model in a decentralized federated learning setting for endovascular intervention. To ensure the feasibility of the training, we tackle the unseen data issue using differentiable Earth Mover's Distance within a knowledge distillation framework. Once trained, our foundation model's weights provide valuable initialization for downstream tasks, thereby enhancing task-specific performance. Intensive experiments show that our approach achieves new state-of-the-art results, contributing to advancements in endovascular intervention and robotic-assisted endovascular surgery, while addressing

Autonomous mechanical thrombectomy (MT) presents substantial challenges due to highly variable vascular geometries and the requirements for accurate, real-time control. While reinforcement learning (RL) has emerged as a promising paradigm for the automation of endovascular navigation, existing approaches often show limited robustness when faced with diverse patient anatomies or extended navigation horizons. In this work, we investigate a world-model-based framework for autonomous endovascular navigation built on TD-MPC2, a model-based RL method that integrates planning and learned dynamics. We evaluate a TD-MPC2 agent trained on multiple navigation tasks across hold out patient-specific vasculatures and benchmark its performance against the state-of-the-art Soft Actor-Critic (SAC) algorithm agent. Both approaches are further validated in vitro using patient-specific vascular phantoms under fluoroscopic guidance. In simulation, TD-MPC2 demonstrates a significantly higher mean success rate than SAC (58% vs. 36%, p < 0.001), and mean tip contact forces of 0.15 N, well below the proposed 1.5 N vessel rupture threshold. Mean success rates for TD-MPC2 (68%) were comparable to SAC (60%

Remote robotic-assisted endovascular intervention offers a promising approach to reduce clinician radiation exposure and physical strain, while extending specialized vascular care to geographically distant regions. Despite advancements, teleoperated endovascular intervention remains underexplored, especially for time-sensitive interventions like mechanical thrombectomy for acute stroke. The aim of the current review was to determine the evidence regarding teleoperated endovascular robotic systems, covering technical feasibility, communication infrastructure, and clinical outcomes. The review further identified research gaps and future directions. Following PRISMA guidelines, 16 studies were included that met the inclusion criteria out of 2501 initial search results. We found that teleoperated catheters and guidewires, driven by mechanical or electromagnetic systems, can be navigated across distances up to 7000 km. With robust communication infrastructure, network latency remained within clinically acceptable limits (30-163 ms). Although initial outcomes highlighted 100% procedural success in small-scale human trials, most evidence stemmed from animal or phantom models. Overall, the

Cardiovascular diseases remain the leading cause of global mortality, with minimally invasive treatment options offered through endovascular interventions. However, the precision and adaptability of current robotic systems for endovascular navigation are limited by heuristic control, low autonomy, and the absence of haptic feedback. This thesis presents an integrated AI-driven framework for autonomous guidewire navigation in complex vascular environments, addressing key challenges in data availability, simulation fidelity, and navigational accuracy. A high-fidelity, real-time simulation platform, CathSim, is introduced for reinforcement learning based catheter navigation, featuring anatomically accurate vascular models and contact dynamics. Building on CathSim, the Expert Navigation Network is developed, a policy that fuses visual, kinematic, and force feedback for autonomous tool control. To mitigate data scarcity, the open-source, bi-planar fluoroscopic dataset Guide3D is proposed, comprising more than 8,700 annotated images for 3D guidewire reconstruction. Finally, SplineFormer, a transformer-based model, is introduced to directly predict guidewire geometry as continuous B-splin

Abdominal Aortic Aneurysms (AAA) are often repaired through an Endovascular approach known as EVAR. The success and duration of these challenging procedures are primarily attributable to the accuracy and reliability of navigating corresponding interventional devices. This study investigates the performance of conventional non-steerable and steerable catheters in endovascular aneurysm repair (EVAR) procedures, focusing on two primary metrics: reachable workspace and gate cannulation success. We developed two abdominal aortic aneurysm (AAA) phantoms using patient CT images for our experiments. Under X-ray fluoroscopy guidance, the reachable workspace was quantified, and gate cannulation success rates, cannulation time, and fluoroscopy times were recorded for both non-steerable and steerable catheters and were compared. We were unable to observe statistically significant differences between the two catheter types in overall cannulation success rates or fluoroscopy time. However, in challenging anatomical scenarios (particularly a more challenging gate location), the steerable catheter showed statistically significant advantages in success rates and cannulation times. While there were

Purpose: Autonomous navigation of devices in endovascular interventions can decrease operation times, improve decision-making during surgery, and reduce operator radiation exposure while increasing access to treatment. This systematic review explores recent literature to assess the impact, challenges, and opportunities artificial intelligence (AI) has for the autonomous endovascular intervention navigation. Methods: PubMed and IEEEXplore databases were queried. Eligibility criteria included studies investigating the use of AI in enabling the autonomous navigation of catheters/guidewires in endovascular interventions. Following PRISMA, articles were assessed using QUADAS-2. PROSPERO: CRD42023392259. Results: Among 462 studies, fourteen met inclusion criteria. Reinforcement learning (9/14, 64%) and learning from demonstration (7/14, 50%) were used as data-driven models for autonomous navigation. Studies predominantly utilised physical phantoms (10/14, 71%) and in silico (4/14, 29%) models. Experiments within or around the blood vessels of the heart were reported by the majority of studies (10/14, 71%), while simple non-anatomical vessel platforms were used in three studies (3/14, 21%

To navigate medical instruments safely and accurately inside a patient's vascular tree, combining X-ray fluoroscopy with intermittent contrast injections is the gold standard. However, prolonged exposure to ionizing radiation poses health risks, necessitates the use of cumbersome lead vests for the clinicians, and contrast injections can lead to acute kidney injury in patients. Bioelectric Navigation, a non-fluoroscopic tracking modality, aims to provide an alternative. It uses weak electric currents to detect local anatomical features in the vasculature and localize instruments without x-ray imaging. In this work, we advance Bioelectric Navigation on two frontiers. Firstly, we introduce a new class of bespokely designed electrode catheters. They are fabricated using 3D printing, thermal drawing, and laser micro-machining. Specifically, we manufacture a 6 Fr catheter incorporating 16 electrodes, a guidewire channel and an additional sensor compartment. We thoroughly assess the catheter's mechanical and electrical properties. Secondly, we introduce an algorithm to localize the catheter along the centerline of a vascular phantom, for the first time fusing electric detection of vascul

An Oculomotor Brain-Computer Interface (BCI) records neural activity from regions of the brain involved in planning eye movements and translates this activity into control commands. While previous successful oculomotor BCI studies primarily relied on invasive microelectrode implants in non-human primates, this study investigates the feasibility of an oculomotor BCI using a minimally invasive endovascular Stentrode device implanted near the supplementary motor area in a patient with amyotrophic lateral sclerosis (ALS). To achieve this, self-paced visually-guided and free-viewing saccade tasks were designed, in which the participant performed saccades in four directions (left, right, up, down), with simultaneous recording of endovascular EEG and eye gaze. The visually guided saccades were cued with visual stimuli, whereas the free-viewing saccades were self-directed without explicit cues. The results showed that while the neural responses of visually guided saccades overlapped with the cue-evoked potentials, the free-viewing saccades exhibited distinct saccade-related potentials that began shortly before eye movement, peaked approximately 50 ms after saccade onset, and persisted for

Autonomous robots in endovascular operations have the potential to navigate circulatory systems safely and reliably while decreasing the susceptibility to human errors. However, there are numerous challenges involved with the process of training such robots, such as long training duration and safety issues arising from the interaction between the catheter and the aorta. Recently, endovascular simulators have been employed for medical training but generally do not conform to autonomous catheterization. Furthermore, most current simulators are closed-source, which hinders the collaborative development of safe and reliable autonomous systems. In this work, we introduce CathSim, an open-source simulation environment that accelerates the development of machine learning algorithms for autonomous endovascular navigation. We first simulate the high-fidelity catheter and aorta with a state-of-the-art endovascular robot. We then provide the capability of real-time force sensing between the catheter and the aorta in simulation. Furthermore, we validate our simulator by conducting two different catheterization tasks using two popular reinforcement learning algorithms. The experimental results

Autonomous microrobots in blood vessels could enable minimally invasive therapies, but navigation is challenged by dense, moving obstacles. We propose a real-time path planning framework that couples an analytic geometry global planner (AGP) with two reactive local escape controllers, one based on rules and one based on reinforcement learning, to handle sudden moving obstacles. Using real-time imaging, the system estimates the positions of the microrobot, obstacles, and targets and computes collision-free motions. In simulation, AGP yields shorter paths and faster planning than weighted A* (WA*), particle swarm optimization (PSO), and rapidly exploring random trees (RRT), while maintaining feasibility and determinism. We extend AGP from 2D to 3D without loss of speed. In both simulations and experiments, the combined global planner and local controllers reliably avoid moving obstacles and reach targets. The average planning time is 40 ms per frame, compatible with 25 fps image acquisition and real-time closed-loop control. These results advance autonomous microrobot navigation and targeted drug delivery in vascular environments.