Case-Based Simulation to Support Complex Active Catheterization: Preliminary Results

Objective

Active catheters are intended to support endovascular navigation in complex anatomies. Nevertheless, their configuration and utilization are challenging. Finite element (FE) modeling representing the navigation of active guidewires alongside catheters can be considered at an early stage to identify the best parameters and support physicians in their planning and procedure. However, FE simulations require significant computation time. We introduce the concept of case-based simulation (CBS) to quickly find adequate configuration parameters for complex catheterization scenarios.

Method

Combining case-based reasoning and FE simulation, CBS approach is considered to reuse design and navigation parameters from previous simulations. A case base is made of successful catheterization simulations performed on reference aorta geometries. For a new patient, a distance metric based on a statistical shape model is used to determine appropriate catheterization parameters from previously simulated cases. The proof-of-concept of this method is performed in the case of the navigation from the aortic arch to the left carotid artery. Among 11 patient-specific aortic arches, three were selected for the reference FE simulations of the left carotid artery hooking to constitute the case base and three others were selected for evaluation.

Results

The retrieved parameters allowed a successful simulated navigation in 100% of the test cases. This demonstrates that the proposed approach can effectively and instantaneously determine appropriate design and navigation parameters for complex catheterization scenarios.