Augmented and Mixed Reality Imaging in Endovascular Procedures: Futuristic but Will It Be Adopted by All?

Modern developments in medical and surgical practice in the last century have been based on improved imaging and the development of newer imaging modalities. This has allowed non-invasive accurate diagnosis in many areas. Imaging data are also used to plan treatments and improve therapeutics. Endovascular aneurysm repair is an example of this. The next phase of development is to use digital images in three dimensions and apply them to patients to facilitate their treatment. Holographic imaging takes this further into the future. This report on the use of HoloLens (Microsoft, Redmond, WA, USA) provides insight into what the future may hold.1Mialhe C. Raffort J. Lareyre F. Holographic imaging in HoloLens head mounted system to enhance angio suite ergonomics during endovascular procedure.Eur J Vasc Endovasc Surg. 2021; 61: 849-850Abstract Full Text Full Text PDF Scopus (1) Google Scholar Augmented reality overlays digital content on the real world, enhancing reality with superimposed information. Mixed reality, also known as merged reality, represents the fusion of both virtual and real world environments, where digital and physical objects co-exist and can interact with each other.2Park B.J. Hunt S.J. Martin 3rd, C. Nadolski G.J. Wood B.J. Gade T.P. Augmented and mixed reality: technologies for enhancing the future of IR.J Vasc Interv Radiol. 2020; 31: 1074-1082Abstract Full Text Full Text PDF PubMed Scopus (23) Google Scholar HoloLens is a pair of mixed reality smartglasses, using a head mounted display unit connected to an adjustable, cushioned inner headband, which can tilt HoloLens up and down, as well as forward and backward. The authors used the devise to project the angiographic images simultaneously while performing an endovascular procedure by creating a programme that displayed holograms in the operator’s visual field. The images are superimposed on the real environment, which naturally facilitated the procedure. However, the role of this technology needs to be defined and validated by evidence based studies. It appears promising mainly in improving ease of image visualisation by endovascular specialists, but whether it translates into reduced procedure time, contrast volume, or radiation exposure will be interesting to see. There may be other questions as well: Do the assistants need separate glasses? Will carrying it cause neck pain, headache, or motion sickness, as warned by Microsoft?3Microsoft Product safety warnings and instructions.https://www.microsoft.com/en-us/hololens/legal/health-and-safety-informationDate accessed: February 10, 2021Google Scholar Will it be adopted by all of us or remain a tool for the enthusiast? So, what the future holds will literally be quite interesting to see! Holographic Imaging with the HoloLens Head Mounted System to Enhance Angio Suite Ergonomics During an Endovascular ProcedureEuropean Journal of Vascular and Endovascular SurgeryVol. 61Issue 5PreviewAugmented reality (AR) technology consists of adding digital information to the direct view of an existing physical environment, and its application in enhancing visualisation has recently emerged in medical imaging. HoloLens glasses (Microsoft, Redmond, WA, USA) are an optical see through head mounted display (HMD), currently considered to be one of the most suitable augmented reality devices for surgery, enabling visualisation of virtual objects superimposed on the real environment. Endovascular surgery requires peri-operative digital subtraction angiography, which is currently visualised on a display screen, leading to transient loss of direct vision of the surgical field, possibly requiring increased focusing changes and hand–eye coordination. Full-Text PDF Open Archive