Journal of Imaging (Mar 2024)

Comparing Different Registration and Visualization Methods for Navigated Common Femoral Arterial Access—A Phantom Model Study Using Mixed Reality

  • Johannes Hatzl,
  • Daniel Henning,
  • Dittmar Böckler,
  • Niklas Hartmann,
  • Katrin Meisenbacher,
  • Christian Uhl

DOI
https://doi.org/10.3390/jimaging10040076
Journal volume & issue
Vol. 10, no. 4
p. 76

Abstract

Read online

Mixed reality (MxR) enables the projection of virtual three-dimensional objects into the user’s field of view via a head-mounted display (HMD). This phantom model study investigated three different workflows for navigated common femoral arterial (CFA) access and compared it to a conventional sonography-guided technique as a control. A total of 160 punctures were performed by 10 operators (5 experts and 5 non-experts). A successful CFA puncture was defined as puncture at the mid-level of the femoral head with the needle tip at the central lumen line in a 0° coronary insertion angle and a 45° sagittal insertion angle. Positional errors were quantified using cone-beam computed tomography following each attempt. Mixed effect modeling revealed that the distance from the needle entry site to the mid-level of the femoral head is significantly shorter for navigated techniques than for the control group. This highlights that three-dimensional visualization could increase the safety of CFA access. However, the navigated workflows are infrastructurally complex with limited usability and are associated with relevant cost. While navigated techniques appear as a potentially beneficial adjunct for safe CFA access, future developments should aim to reduce workflow complexity, avoid optical tracking systems, and offer more pragmatic methods of registration and instrument tracking.

Keywords