Dr. Igor Koncar from the University of Belgrade recently shared a retrospective case with us to review using Avatar Medical's Virtual Reality software and its effectiveness for planning and confirming the success of complex vascular procedures. This is a 48-year-old male with a challenging medical profile, including severe hypertension, a stress-laden lifestyle with probable substance use, and obesity.

The patient presented with intense back pain and uncontrolled hypertension. Despite initial treatments, his condition was deteriorating, evidenced by worsening MDCT scans, persistent pain, escalating blood pressure levels, and finally renal failure.

Given the complexity of the case and the rapid decline in the patient's health, he opted for a cutting-edge endovascular strategy. The procedure involved the meticulous placement of a thoracic stent graft, which necessitated coverage of the left subclavian artery. We extended the intervention with a ‘stabilize’ technique to the infrarenal segment to uphold the integrity of the affected vasculature.

Understanding the risk of potential ischemic complications, Dr. Koncar concurrently performed a preventive carotid-subclavian bypass. This was crucial to ensure uninterrupted blood flow despite the coverage of the subclavian artery. Additionally, we inserted another stent graft into the right common iliac artery to relieve the persistent arterial compressions/stenosis.

Avatar Medical's Virtual Reality solution was used to retrospectively review the preoperative and postoperative phases for the patient. The novel solution allowed the surgeon to better understand the anatomy of the true and false lumen, and identify thrombus formation, as well as areas that were experiencing a decrease in perfusion.

Postoperatively, the solution was used to confirm restored perfusion as well as stent overlap and placement.

“Understanding the anatomy of this patient would have allowed me to make faster decisions and determine areas of treatment needed in a more palatable time frame. Avatar Medical's advanced imaging is promising for viewing areas of decreased perfusion, and thrombus formation which can greatly impact our surgical strategy” Dr. Koncar

We are delighted to report that the patient made a remarkable recovery and was discharged in good condition. This outcome underscores the importance of multidisciplinary collaboration and the utilization of advanced endovascular techniques.