Chair for Computer Aided Medical Procedures & Augmented Reality
Lehrstuhl für Informatikanwendungen in der Medizin & Augmented Reality

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Endovascular Stenting of Aortic Aneurysms

Endovascular Stenting of Aortic Aneurysms

In medical collaboration with:
St. Olavs Hospital (NTNU, Norway)
Klinikum München-Pasing
Klinikum rechts der Isar
Klinikum Innenstadt

In academic collaboration with:
SINTEF Medical Imaging

Scientific Director: Nassir Navab

Contact Person(s): Stefanie Demirci

Keywords: Computer-Aided Surgery, Past Projects


Endovascular stenting is a minimally invasive treatment technique for aortic aneurysms or dissections. Thereby, a certain aortic prosthesis (stent graft) is placed inside the aortic aneurysm in order to prevent a life-threatening rupture of the aortic wall. Prior to the intervention, a computed tomography angiography (CTA) is acquired on which the surgical staff can measure the parameter of the desired stent graft and finalize the intervention workflow. The entire interventional catheter navigation is done under 2D angiography imaging where the physician is missing the important 3D information. The purpose of our project is two-fold:
1. In the planning phase, a modified graph cuts algorithm automatically segments the aorta and aneurysm, so the surgical staff can choose an appropriate type of stent to match the segmented location, length, and diameter of the aneurysm and aorta. By visualizing the defined stent graft next to the three-dimensionally reconstructed aneurysm, mismeasurements can be detected in an early stage. Our main goal is the creation of an interactive simulation system that predicts the behaviour of the aortic wall and the movement of the implanted stent graft.
2. During implantation of the stent graft, after an intensity based registration of CTA and angiography data, the current navigation can be visualized in the 3D CT data set at any time. This includes solutions for electro-magnetic tracking of catheters as well as guide wires and stent grafts. Eventually, Our main goal is the creation of solutions that enable the surgeon to enhance the accuracy of the navigation and positioning, along with a minimum use of angiography, leading to less radiation exposure and less contrast agent injection.


Figure 1:
Figure 2: Volume Rendering of CTA after stent implantation in decending aorta
Figure 3: Disocclusion for Medical Image Registration: original image(top left), Stent-editing (top right), spline interpolation (lower left), digital inpainintg (lower right) of the occlusion.

Depth Recovery from Single View Simulated X-ray Images


D. Stoyanov, R. Taylor, S. Balocco, R. Sznitman, A. Martel, L. Maier-Hein, L. Duong, G. Zahnd, S. Demirci, S. Albarqouni, J. Lee, S. Moriconi, V. Cheplygina, D. Mateus, E. Trucco, E. Granger, P. Jannin
Intravascular Imaging and Computer Assisted Stenting and Large-Scale Annotation of Biomedical Data and Expert Label Synthesis
MICCAI 2018 Workshops (bib)
J. Cardoso, T. Arbel, J. Lee, V. Cheplygina, S. Balocco, D. Mateus, G. Zahnd, L. Maier-Hein, S. Demirci, E. Granger, L. Duong, M. A. Carbonneau, S. Albarqouni, G. Carneiro
Intravascular imaging and computer assisted stenting, and large-scale annotation of biomedical data and expert label synthesis
MICCAI 2017 Workshops (bib)
S. Balocco, M. Zuluaga, G. Zahnd, S. L. Lee, S. Demirci
Computing and visualization for intravascular imaging and computer-assisted stenting
ELSEVIER Academic Press (bib)
S. Matl, R. Brosig, M. Baust, N. Navab, S. Demirci
Vascular Image Registration Techniques: A Living Review
Medical Image Analysis, Volume 35, pp. 1-7, 2017 (bib)
S. Albarqouni, U. Konrad, L. Wang, N. Navab, S. Demirci
Single-View X-Ray Depth Recovery: Towards a Novel Concept for Image-Guided Interventions
International Journal of Computer Assisted Radiology and Surgery (IJCARS), 2016, June 2016, Volume 11, Issue 6, pp 873-880. (bib)
S. Virga, V. Dogeanu, P. Fallavollita, R. Ghotbi, N. Navab, S. Demirci
Optimal C-arm Positioning for Aortic Interventions
Bildverarbeitung fuer die Medizin (BVM 2015), Luebeck, Germany, March 2015 (bib)
S.-L. Lee, S. Balocco, C. Gatta, S. Demirci, G. A. Tangen
Editorial of the special issue STENT
Computerized Medical Imaging and Graphics, Special Issue STENT, In Press, 2015 (bib)
D. Volpi, M. H. Sarhan, R. Ghotbi, N. Navab, D. Mateus, S. Demirci
Online Tracking of Interventional Devices for Endovascular Aortic Repair
International Journal of Computer Assisted Radiology and Surgery, June 2015, Volume 10, Issue 6, pp 773-781 (bib)
S.-L. Lee, S. Demirci, P. Radeva, G. Unal
Editorial Note
Computerized Medical Imaging and Graphics, vol. 38, pages 69-69, 2014 (bib)
S. Demirci, F. Manstad-Hulaas, N. Navab
Interventional 2D-3D Registration in the Presence of Occlusion
XIII Mediterranean Conference on Medical and Biological Engineering and Computing 2013, IFMBE Proceedings Volume 41, 2014, pp 277-280. (bib)
S. Demirci, M. Baust, O. Kutter, F. Manstad-Hulaas, H-H. Eckstein, N. Navab
Disocclusion-based 2D-3D Registration for Aortic Interventions
Computers in Biology and Medicine, Volume 43, Issue 4, 1 May 2013, Pages 312-322 (bib)
S. Demirci, A. Bigdelou, L. Wang, C. Wachinger, M. Baust, R. Tibrewal, R. Ghotbi, H-H. Eckstein, N. Navab
3D Stent Recovery from One X-ray Projection
14th International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI), Toronto (CA), September 18-22, 2011 (bib)
F. Manstad-Hulaas, G. A. Tangen, S. Demirci, M. Pfister, S. Lydersen, T. A. Nagelhus Hernes
Endovascular Image-Guided Navigation - Validation of Two Volume-Volume Registration Algorithms
Minimally Invasive Therapy & Allied Technologies 20(5), pp. 282 - 289, 2011 (bib)
S. Demirci, G. Lejeune, N. Navab
Hybrid Deformable Model for Aneurysm Segmentation
Biomedical Imaging: From Nano to Macro, 2009. ISBI '09. IEEE International Symposium on, pp. 33-36, 2009. (bib)
S. Demirci, F. Manstad-Hulaas, N. Navab
Extracting a Purely Non-Rigid Deformation Field of a Single Structure
Proceedings of Bildverarbeitung fuer die Medizin (BVM 2009), Heidelberg, Germany, March 2009 (bib)
S. Demirci, F. Manstad-Hulaas, N. Navab
Quantification of Abdominal Aortic Deformation after EVAR
Proc. SPIE 7261, Medical Imaging 2009: Visualization, Image-Guided Procedures, and Modeling, 72611U, February 2009 (bib)
S. Demirci, O. Kutter, F. Manstad-Hulaas, R. Bauernschmitt, N. Navab
Advanced 2D-3D Registration for Endovascular Aortic Interventions: Addressing Dissimilarity in Images
Proc. SPIE 6918, Medical Imaging 2008: Visualization, Image-guided Procedures, and Modeling, 69182S, February 2008 (bib)
O. Kutter, S. Kettner, E.U. Braun, N. Navab, R. Lange, R. Bauernschmitt
Towards an Integrated Planning and Navigation System for Aortic Stent-Graft Placement
Proc. of Computer Assisted Radiology and Surgery (CARS), Berlin, Germany, June 2007. (bib)
M. Feuerstein, K. Filippatos, O. Kutter, E.U. Schirmbeck, R. Bauernschmitt, N. Navab
A Novel Segmentation and Navigation Tool for Endovascular Stenting of Aortic Aneurysms
International Journal of Computer Assisted Radiology and Surgery, 2006; Vol. 1 Suppl. 1, page 280 - 282.
The original publication is available online at
R. Bauernschmitt, M. Feuerstein, E.U. Schirmbeck, N. Augustin, S.M. Wildhirt, R. Lange
Improvement of Endovascular Stent Grafting by Augmented Reality
Biomedizinische Technik (BMT 2005), Volume 50, Supplementary vol. 1, Part 2, pp. 1262 - 1263, Nuremberg, Germany, September 2005 (bib)
R. Bauernschmitt, E.U. Schirmbeck, M. Groher, P. Keitler, M. Bauer, H. Najafi, G. Klinker, R. Lange
Navigierte Platzierung endovaskulärer Aortenstents
Z Kardiologie 2004 93 S3: 116 (bib)


Contact Person(s)

Stefanie Demirci
Dr. Stefanie Demirci

Working Group

Shadi Albarqouni
Dr. Shadi Albarqouni


Ali Bigdelou
Dr. Ali Bigdelou
Kanishka Sharma
Dr. Kanishka Sharma
Marco Feuerstein
Dr. Marco Feuerstein
Martin Groher
Dr. Martin Groher
Oliver Kutter
Dr. Oliver Kutter
Peter Keitler
Dr. Peter Keitler


Technische Universität München
Institut für Informatik / I16
Boltzmannstr. 3
85748 Garching bei München

Tel.: +49 89 289-17058
Fax: +49 89 289-17059
Visit our lab at Garching.

Ludwig-Maximilians-Universität München
Chirurgische Klinik und Poliklinik - Innenstadt, AG CAS
Nussbaumstr. 20
80336 München

Room: C2.06
Tel.: +49 89 5160-3615
Tel.: +49 89 5160-3635
Fax: +49 89 5160-3630
Visit our lab at Klinikum Innenstadt.

Klinikum rechts der Isar
der Technischen Universitüt München
Ismaninger Str. 22
81675 München

IFL Lab - Room: 01.3a-c
Tel.: +49 89 4140-6457
Fax: +49 89 4140-6458
Visit our lab at Klinikum rechts der Isar.

internal project page

Please contact Stefanie Demirci for available student projects within this research project.

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