دورية أكاديمية
First Experience With Augmented Reality Guidance for Cerebral Embolic Protection During TAVR.
| العنوان: | First Experience With Augmented Reality Guidance for Cerebral Embolic Protection During TAVR. |
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| المؤلفون: | Sadri S; Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA., Loeb GJ; Department of Radiology, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA., Grinshpoon A; Department of Computer Science, Columbia University, New York, New York, USA., Elvezio C; Department of Computer Science, Columbia University, New York, New York, USA., Sun SH; Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA., Ng VG; Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA., Khalique O; Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA., Moses JW; Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA., Einstein AJ; Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA., Patel AJ; Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA., George I; Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA., Hahn RT; Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA., Nazif TM; Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA., Leon MB; Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA., Kirtane AJ; Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA., Kodali SK; Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA., Feiner SK; Department of Computer Science, Columbia University, New York, New York, USA., Vahl TP; Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA. |
| المصدر: | JACC. Advances [JACC Adv] 2024 Feb 07; Vol. 3 (3), pp. 100839. Date of Electronic Publication: 2024 Feb 07 (Print Publication: 2024). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Inc Country of Publication: United States NLM ID: 9918419284106676 Publication Model: eCollection Cited Medium: Internet ISSN: 2772-963X (Electronic) Linking ISSN: 2772963X NLM ISO Abbreviation: JACC Adv Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: [New York] : Elsevier Inc., [2022]- |
| مستخلص: | Background: Augmented reality (AR) guidance holds potential to improve transcatheter interventions by enabling visualization of and interaction with patient-specific 3-dimensional virtual content. Positioning of cerebral embolic protection devices (CEP) during transcatheter aortic valve replacement (TAVR) increases patient exposure to radiation and iodinated contrast, and increases procedure time. AR may enhance procedural guidance and facilitate a safer intervention. Objectives: The purpose of this study was to develop and test a novel AR guidance system with a custom user interface that displays virtual, patient-specific 3-dimensional anatomic models, and assess its intraprocedural impact during CEP placement in TAVR. Methods: Patients undergoing CEP during TAVR were prospectively enrolled and assigned to either AR guidance or control groups. Primary endpoints were contrast volume used prior to filter placement, times to filter placement, and fluoroscopy time. Postprocedure questionnaires were administered to assess intraprocedural physician experience with AR guidance. Results: A total of 24 patients presenting for TAVR were enrolled in the study (12 with AR guidance and 12 controls). AR guidance eliminated the need for aortic arch angiograms prior to device placement thus reducing contrast volume (0 mL vs 15 mL, P < 0.0001). There was no significant difference in the time required for filter placement or fluoroscopy time. Postprocedure questionnaires indicated that AR guidance increased confidence in wiring of the aortic arch and facilitated easier device placement. Conclusions: We developed a novel AR guidance system that eliminated the need for additional intraprocedural angiograms prior to device placement without any significant difference in time to intervention and offered a subjective improvement in performance of the intervention. Competing Interests: This work was supported by the 10.13039/100000001National Science Foundation under Grant IIS-1514429 (S. Feiner, PI), the 10.13039/100000002National Institutes of Health under Grant 10.13039/100000050NHLBI: 5T35HL007616-37 (R. Leibel, PI), and Columbia University Vagelos College of Physicians and Surgeons under Dean’s Research Fellowships to S. Sadri, G. Loeb, and S. Sun. Alon Grinshpoon is Founder and Chief Executive Officer of echoAR, Inc., which is unrelated to the contents of this paper. Dr Khalique has received speaker fees from Edwards Lifesciences and has received consulting fees from Abbott Structural and Boston Scientific. Dr Einstein has served as a consultant to W. L. Gore and Associates; his institution receives funding from 10.13039/100000002NIH, International Atomic Energy Agency, 10.13039/100020498Canon Medical Systems USA, Roche Medical Systems, 10.13039/100020453W. L. Gore and Associates, and 10.13039/100006775GE Healthcare. Dr George has served as a consultant for Atricure, WL Gore, MitreMedical, VDyne, CardioMech, and Neptune Medical. Dr Hahn reports speaker fees from Edwards Lifescience; consulting for Abbott Vascular, Boston Scientific, Gore&Associates, Medtronic; Equity with Navigate; and is the Chief Scientific Officer for the Echocardiography Core Laboratory at the Cardiovascular Research Foundation for multiple industry-sponsored trials, for which she receives no direct industry compensation. Dr Nazif has served as a consultant for Edwards Lifesciences, Boston Scientific, Medtronic, and BioTrace. Dr Leon has received institutional research support from 10.13039/100006520Edwards Lifesciences, 10.13039/100004374Medtronic, 10.13039/100008497Boston Scientific, and 10.13039/100000046Abbott; and has served on the consulting/Advisory Board for Medtronic, Boston Scientific, Gore, Meril Lifescience, and Abbott. Dr Kirtane has received institutional research support and personal fees from 10.13039/100004374Medtronic, 10.13039/100011949Abbott Vascular, 10.13039/100008497Boston Scientific, 10.13039/100020297Abiomed, CathWorks, 10.13039/100005333CSI, 10.13039/100004340Siemens, Philips, 10.13039/100015371ReCor Medical, and Spectranetics. Dr Kodali has received institutional research grants or honoraria from 10.13039/100006520Edwards Lifesciences, 10.13039/100008497Boston Scientific, 10.13039/100019998JenaValve, 10.13039/100004374Medtronic, and 10.13039/100000046Abbott; has received consulting fees from Abbott, Admedus, and Meril Lifesciences; and has equity options in Biotrace Medical, Thubrikar Aortic Valve, Inc., Dura Biotech, Microinterventional Devices, Supira, and Admedus. Dr Feiner serves on the Advisory Board for Contextere (New York, NY) and Infiniverse, Inc. (Wilmington, DE). Dr Vahl has received grant and research support from 10.13039/100006520Edwards Lifesciences, 10.13039/100004374Medtronic, 10.13039/100019998JenaValve Technology, and 10.13039/100015696Siemens Healthineers; and has received consulting fees from JenaValve, Siemens Healthineers, and Abbott. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. (© 2024 The Authors.) |
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| معلومات مُعتمدة: | T35 HL007616 United States HL NHLBI NIH HHS |
| فهرسة مساهمة: | Keywords: TAVR; augmented reality; image guidance; mixed reality; virtual reality |
| تواريخ الأحداث: | Date Created: 20240628 Latest Revision: 20240630 |
| رمز التحديث: | 20240630 |
| مُعرف محوري في PubMed: | PMC11198681 |
| DOI: | 10.1016/j.jacadv.2024.100839 |
| PMID: | 38938839 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 2772-963X |
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| DOI: | 10.1016/j.jacadv.2024.100839 |