Augmented reality as a method of neuronavigation in microsurgical treatment of cerebrovascular diseases: description of the method and clinical experience
An N Konovalov, D N Okishev, Yu V Pilipenko, Shalva Sh. Eliava, A. A. Artemyev, Vladimir Mikhaylovich Ivanov, Anton Yu. Smirnov, Sergey Strelkov · Burdenko s Journal of Neurosurgery · 2025
Augmented reality (AR) is a promising area in microsurgical treatment of cerebrovascular pathologies that can significantly facilitate preoperative planning and intraoperative understanding of anatomy. OBJECTIVE: To describe AR-assisted neuronavigation in microsurgical treatment of intracranial aneurysms, arteriovenous malformations and cavernomas; to evaluate accuracy and applicability of AR-assisted neuronavigation. MATERIAL AND METHODS: The study involved 22 patients with cerebral aneurysms, arteriovenous and cavernous malformations. Microsoft Hololens 2 HMD glasses and «Medgital» software for AR navigation were used. Accuracy of registration (TRE and FRE) and time for preoperative preparation were evaluated. RESULTS. MEAN: TRE when using QR code was 0.6±0.2 cm, when combining through craniometric points - 1.4±0.6 cm. Time for preoperative image processing was 24.7±5.1 minutes, application setup in the operating theatre - 1.6±0.2 minutes. Combination using QR code provided higher accuracy of registration compared to craniometric points. AR-assisted navigation improved visualization and planning of surgeries for aneurysms, arteriovenous malformations, microvascular anastomoses and cavernous angiomas. CONCLUSION: AR-assisted navigation is an innovative method with specific advantages that can potentially improve microsurgical treatment of cerebrovascular diseases. Further research is needed to confirm these findings and develop AR technology in neurosurgery.