- ICH GCP
- Yhdysvaltain kliinisten tutkimusten rekisteri
- Kliininen tutkimus NCT07711457
Application of Extended Reality (XR)-Assisted Computed Tomography (CT)-Guided Localization in Extracranial-intracranial (EC-IC) Bypass Surgery
Application of Extended Reality (XR)-Assisted CT-Guided Localization in Extracranial-intracranial (EC-IC) Bypass Surgery
This study will evaluate the application of a metaverse-based surgical simulation platform in extracranial-intracranial (EC-IC) bypass surgery. The study population will include patients with moyamoya disease or chronic cerebral ischemia who are scheduled to undergo EC-IC bypass surgery.
Before surgery, preoperative brain computed tomography images will be imported into the metaverse surgical simulation platform. During surgery, extended reality technology will be used to provide precise localization of the relevant vessels, including both the donor and recipient arteries.
The primary objective is to assess the localization accuracy of this platform. The study will also investigate whether this technology can facilitate a minimally invasive surgical approach and improve surgical safety.
Tutkimuksen yleiskatsaus
Tila
Ehdot
Interventio / Hoito
Opintotyyppi
Ilmoittautuminen (Arvioitu)
Yhteystiedot ja paikat
Opiskeluyhteys
- Nimi: Chiu Hao Hsu
- Puhelinnumero: 73234 88623123456
- Sähköposti: newmanhsu0814@gmail.com
Opiskelupaikat
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Taipei, Taiwan
- Rekrytointi
- National Taiwan University Hospital
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Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
- Aikuinen
- Vanhempi Aikuinen
Hyväksyy terveitä vapaaehtoisia
Näytteenottomenetelmä
Tutkimusväestö
Kuvaus
Inclusion Criteria:
- Adult patients diagnosed with ischemic moyamoya disease, moyamoya syndrome, or chronic intracranial internal carotid artery stenosis or occlusion (chronic ICA stenosis/occlusion).
- Patients scheduled to undergo extracranial-intracranial bypass surgery (EC-IC bypass), including superficial temporal artery-middle cerebral artery bypass (STA-MCA bypass), superficial temporal artery trunk-interposition graft-middle cerebral artery bypass (STA trunk-graft-MCA bypass), or other cerebral revascularization procedures using the superficial temporal artery or another branch of the external carotid artery system (STA/ECA system) as the donor blood supply.
Exclusion Criteria:
- Presence of a contraindication to computed tomography (CT) scanning.
- Presence of a severe systemic illness that would prevent participation in subsequent study assessments, such as poorly controlled diabetes mellitus, active malignancy, or severe cardiac disease.
- The need for emergency surgery without sufficient time to complete image-based modeling and registration.
- Presence of scalp lesions, wounds, or anatomical deformities that prevent reliable surface registration.
- The XR registration result is considered unreliable by the research team and may potentially compromise surgical safety.
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Accuracy of XR-Assisted Superficial Temporal Artery Localization
Aikaikkuna: During preoperative surgical planning and intraoperative confirmation on the day of surgery.
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Accuracy will be assessed as the absolute distance, measured in millimeters, between the superficial temporal artery location marked using the XR-assisted surgical planning system and the actual superficial temporal artery location identified by vascular ultrasonography.
The mean absolute distance error across participants will be reported.
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During preoperative surgical planning and intraoperative confirmation on the day of surgery.
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Accuracy of XR-Assisted Middle Cerebral Artery Recipient-Vessel Prediction
Aikaikkuna: From preoperative surgical planning to intraoperative selection of the recipient vessel on the day of surgery.
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Accuracy will be assessed as the absolute distance, measured in millimeters, between the anastomosis site predicted using the XR-assisted surgical planning system and the actual recipient-vessel anastomosis site selected intraoperatively.
The mean absolute distance error across participants will be reported.
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From preoperative surgical planning to intraoperative selection of the recipient vessel on the day of surgery.
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Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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XR-Assisted STA Localization Time
Aikaikkuna: During preoperative preparation on the day of surgery.
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The time required to localize and mark the superficial temporal artery and middle cerebral artery using the XR-assisted system will be measured in minutes, from initiation of XR registration and localization to completion of skin marking.
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During preoperative preparation on the day of surgery.
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Time From Skin Incision to Identification of the Recipient Vessel
Aikaikkuna: During the surgical procedure on the day of surgery.
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The time from the initial skin incision to intraoperative identification of the middle cerebral artery recipient vessel selected for bypass will be measured in minutes.
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During the surgical procedure on the day of surgery.
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Total Operative Time
Aikaikkuna: During the surgical procedure on the day of surgery.
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Total operative time will be measured in minutes, from the initial skin incision to completion of skin closure.
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During the surgical procedure on the day of surgery.
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Skin-Incision Length
Aikaikkuna: At completion of skin closure on the day of surgery.
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The length of the final skin incision will be measured in centimeters after completion of the surgical procedure.
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At completion of skin closure on the day of surgery.
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Maximum Craniotomy Diameter
Aikaikkuna: During the surgical procedure on the day of surgery.
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The maximum diameter of the completed craniotomy will be measured in centimeters intraoperatively.
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During the surgical procedure on the day of surgery.
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Intraoperative Enlargement of the Planned Craniotomy
Aikaikkuna: During the surgical procedure on the day of surgery.
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The number and percentage of participants requiring intraoperative enlargement of the craniotomy beyond the preoperatively planned dimensions will be reported.
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During the surgical procedure on the day of surgery.
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Intraoperative Bypass Blood Flow
Aikaikkuna: Immediately after completion of the bypass anastomosis on the day of surgery.
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Blood flow through the completed bypass will be measured in milliliters per minute using an intraoperative flow-measurement device after completion of the anastomosis.
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Immediately after completion of the bypass anastomosis on the day of surgery.
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Postoperative Ischemic Complications
Aikaikkuna: From completion of surgery through 30 days after surgery.
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The number and percentage of participants experiencing a new postoperative cerebral ischemic event, including transient ischemic attack or ischemic stroke, will be reported.
Events will be determined by neurological assessment and clinically indicated neuroimaging.
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From completion of surgery through 30 days after surgery.
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Postoperative Hemorrhagic Complications
Aikaikkuna: From completion of surgery through 30 days after surgery.
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The number and percentage of participants experiencing a new postoperative intracranial hemorrhagic complication will be reported.
Events will be determined by neurological assessment and postoperative neuroimaging
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From completion of surgery through 30 days after surgery.
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Change in Modified Rankin Scale Score
Aikaikkuna: From baseline before surgery to 30 days after surgery.
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The change in modified Rankin Scale score will be calculated as the postoperative score minus the preoperative baseline score.
The modified Rankin Scale ranges from 0 to 6, with higher scores indicating greater disability.
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From baseline before surgery to 30 days after surgery.
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Length of Intensive Care Unit Stay
Aikaikkuna: From completion of surgery through discharge from the intensive care unit, up to 30 days after surgery.
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The duration of postoperative intensive care unit stay will be measured in days, from admission to the intensive care unit after surgery to transfer out of the intensive care unit.
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From completion of surgery through discharge from the intensive care unit, up to 30 days after surgery.
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Total Length of Hospital Stay
Aikaikkuna: From the date of surgery through hospital discharge, up to 30 days after surgery.
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The total postoperative hospital stay will be measured in days, from the date of surgery to the date of hospital discharge.
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From the date of surgery through hospital discharge, up to 30 days after surgery.
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Yhteistyökumppanit ja tutkijat
Sponsori
Julkaisuja ja hyödyllisiä linkkejä
Yleiset julkaisut
- Saemann A, de Wilde D, Guzman R, Soleman J, Greuter L. Augmented and Virtual Reality in Open Neurovascular Surgery: A Systematic Review of the Literature. World Neurosurg. 2026 Jan;205:124632. doi: 10.1016/j.wneu.2025.124632. Epub 2025 Nov 6.
- Bhatia S, Huynh A, Shanahan RM, Kann MR, Gopakumar A, Sharma N, Kass NM, Hurt G, Basdeo R, Don N, Lang MJ, Biehl JT, Andrews EG. Optimizing the Workflow of Superficial Temporal Artery Mapping in Extracranial-Intracranial Bypass Surgery Using Mixed Reality: A Proof-of-Concept Study. World Neurosurg. 2025 Dec;204:124562. doi: 10.1016/j.wneu.2025.124562. Epub 2025 Oct 13.
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Todellinen)
Ensisijainen valmistuminen (Arvioitu)
Opintojen valmistuminen (Arvioitu)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
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