Siemens Healthcare presented the Evar Guidance Engine software application package to support minimally invasive treatment of aortic aneurysms at the Charing Cross Congress in London. This is the first application package that enables an automated workflow for stent placement with fusion imaging.

Evar Guidance Engine supports the entire surgical process using automated workflows, from analysis of the pre-procedural CT images to image-supported intervention and intra-operative 3D monitoring. The CT image is prepared automatically for overlaying with the 2D x-ray image, a process known as fusion imaging. Evar Guidance Engine recognizes the vessel walls in the aorta, also marks the main vessels branching away from it, and calculates the ideal angulation for the C-arm.

At this point the anatomical markings on the pre-procedural CT image can be displayed on the x-ray image to serve as a guide for the surgeon, enabling the stent to be precisely positioned.

This fusion imaging in the hybrid OR reduces both the radiation dose required and the dose of contrast media for the patient, compared to traditional methods without 3D imaging support. This makes highly accurate stent positioning possible, while also reducing the duration of surgery.

Dr. Philipp Geisbuesch, vascular surgeon at the Heidelberg University Hospital, who is already working with a prototype of the new software, said “The optical system is an absolute winner, since you always have all the key orientation points in view. I can always see where the renal artery is, and which angulation I need to select. Fusion imaging enables us to place the endograft with maximum accuracy and the correct angulation. All with minimum use of contrast media.”

The results can be assessed immediately following surgery using syngo DynaCT 3D imaging – something that’s essential for Geisbuesch: “Using this contrast-enhanced cone beam CT, we discovered associated endograft or other complications in seven percent of patients that we could immediately repair on the table. Now we can be sure: once we bring our patient out of the operating room, everything that could be done has been done.”

Evar Guidance Engine will be available as part of the Pure platform for the Artis zee, Artis Q, Artis zeego and Artis Q.zen angiography systems.