Until today endovascular aneurysm repair (EVAR) has been performed in two dimensions using traditional fluoroscopy. Siemens directs EVAR into the third dimension and calls it EVAR-3D Guidance.
EVAR-3D Guidance overlays 3D information on top of live fluoroscopy and delivers (a) optimized C-arm angulations, (b) precise 3D overlay, and (c) guidewire and catheter navigation.
In general, stiff catheters deform the iliac arteries and the aorta when advanced into the aorta. Thus, the anatomy in preoperative images might not exactly match the intra-operative situation. Therefore, information derived from preoperative images or images acquired before the catheters are inserted might not meet the accuracy required for precise 3D guidance. In contrast, during EVAR-3D Guidance the catheter with the endograft is inserted in the aorta but not released before the actual 3D syngo DynaCT acquisition. By acquiring the 3D image after inserting the catheter, the deformations are captured in the 3D image and the final overlay of the 3D image matches the live fluoroscopy with minimal distortions.