Augmented Reality in Neurovascular Surgery: First Experiences

In neurovascular surgery, the surgeon must navigate among eloquent areas, through complex neurovascular anatomy to a particular vascular malformation or anomaly. Augmented reality (AR) visualization may be used to show vessels not visible when looking at the brain surface and to aid navigation by bringing into spatial alignment pre-operative vascular data with the real patient anatomy. In using AR, we may aid the surgeon in planning the craniotomy to obtain the optimal resection corridor and reduce the time to localize and identify important vessels. In the following paper, we describe the first uses of our AR neuronavigation system in the operating room (OR). Specifically, we describe the system’s use in three different neurovascular cases, an aneurysm case, an arteriovenous malfromation, and a dural arteriovenous fistula. Furthermore, we give a qualitative evaluation based on comments from the OR and post-operative discussions with the neurosurgeons.