World’s first as virtual reality used to guide human coronary procedure.


Chronic total occlusion, the complete blockage of the coronary artery, represents a major challenge for cardiologists globally. The situation is driven by the unpredictable surgical success rates related to the difficulty of recanalizing chronic total occlusions as well as incomplete visualization of the occluded coronary arteries by conventional coronary angiography radiology methods.  Consequently, there is substantial interest in new imaging methods enabling success rates in surgery for chronic total occlusion.  Now, researchers at the Institute of Cardiology, Warsaw have successfully used a Virtual Reality-based device (VR) to guide the revascularization of a chronically blocked right coronary artery. The study is published in the Canadian Journal of Cardiology.

Previous studies show that coronary computed tomography angiography (CTA) is increasingly used to provide physicians with guidance when performing catheter-based percutaneous coronary intervention for chronic total occlusion. With the occluded coronary segment and the distal vessel territory being shown to be more clearly depicted using coronary CTA than in invasive angiography. Of particular interest, the procedure itself can be facilitated by projection of three-dimensional CTA data sets on separate monitors in the catheterization laboratory, however, this technique is constrained by economic and technical factors.  Virtual reality has potential to revolutionize some aspects of medicine and healthcare. Several medical specialties are already using it to train physicians and assist diagnosis and it also has potential for treatment.  The current study was able to successfully restore blood flow in the occluded right coronary artery of a 49-year-old male patient assisted by a VR device based on Google Glass, an optical head-mounted display.

The current study utilised the display of three-dimensional VR computed tomographic reconstructions controlled with a hands-free voice recognition system and a zoom function.  Results show the VR-device enabled the cardiologists to clearly visualize the distal coronary vessel and verify the direction of the guide wire advancement relative to the course of the blocked vessel segment; the procedure was completed successfully with implantation of two drug-eluting stents.

The lab explain that the device used, Google Glass, consists of a wearable, hands-free computer with an optical head-mounted display. They go on to add that the optical head-mounted display can display and capture images and videos while interacting with the surrounding environment; this display is an example of the concept of Augmented Reality in which the user is supplemented with additional information generated by the device in real-time.

Data findings show that the novel application of VR wearable devices for display of CTA data sets in the catheterization laboratory can be used for better planning and guidance of interventional procedures, and provides proof of concept that wearable computers can improve operator comfort and efficiency in interventional cardiology.

The team surmise that their mobile technology is easily accessible and offers an incremental opportunity to expand the existing open platform for mobile applications, such as Virtual or Augmented Reality, which in turn might help to overcome the economic and capacity limitations of advanced angiography systems with dedicated monitors for projection of CTA data sets.  For the future, the researchers state that wearable VR-computers have great potential to optimize percutaneous revascularization, and favorably affect interventional cardiologists in their daily clinical activities.

Source: Canadian Cardiovascular Society

 

These are CTA images displayed in Google Glass. (A) Cardiologist viewing the CTA images in the upper right visual field on Google Glass (Google Inc, Mountain View, CA) (arrow) during a CTO recanalization attempt. (B, C) Three-dimensional reconstructions projected directly onto the Google Glass screen reveal the exact trajectory of the distal right coronary artery (RCA, arrows). CTA, computed tomography angiography; CTO, chronic total occlusion; RCA, right coronary artery.  Credit: Canadian Journal of Cardiology.

These are CTA images displayed in Google Glass. (A) Cardiologist viewing the CTA images in the upper right visual field on Google Glass (Google Inc, Mountain View, CA) (arrow) during a CTO recanalization attempt. (B, C) Three-dimensional reconstructions projected directly onto the Google Glass screen reveal the exact trajectory of the distal right coronary artery (RCA, arrows). CTA, computed tomography angiography; CTO, chronic total occlusion; RCA, right coronary artery. Credit: Canadian Journal of Cardiology.

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