{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:56:06Z","timestamp":1760144166255,"version":"build-2065373602"},"reference-count":34,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T00:00:00Z","timestamp":1711324800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Dietmar Hopp-Stiftung"},{"name":"Heidelberger Stiftung Chirurgie"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Imaging"],"abstract":"<jats:p>Mixed reality (MxR) enables the projection of virtual three-dimensional objects into the user\u2019s field of view via a head-mounted display (HMD). This phantom model study investigated three different workflows for navigated common femoral arterial (CFA) access and compared it to a conventional sonography-guided technique as a control. A total of 160 punctures were performed by 10 operators (5 experts and 5 non-experts). A successful CFA puncture was defined as puncture at the mid-level of the femoral head with the needle tip at the central lumen line in a 0\u00b0 coronary insertion angle and a 45\u00b0 sagittal insertion angle. Positional errors were quantified using cone-beam computed tomography following each attempt. Mixed effect modeling revealed that the distance from the needle entry site to the mid-level of the femoral head is significantly shorter for navigated techniques than for the control group. This highlights that three-dimensional visualization could increase the safety of CFA access. However, the navigated workflows are infrastructurally complex with limited usability and are associated with relevant cost. While navigated techniques appear as a potentially beneficial adjunct for safe CFA access, future developments should aim to reduce workflow complexity, avoid optical tracking systems, and offer more pragmatic methods of registration and instrument tracking.<\/jats:p>","DOI":"10.3390\/jimaging10040076","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T14:00:23Z","timestamp":1711375223000},"page":"76","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparing Different Registration and Visualization Methods for Navigated Common Femoral Arterial Access\u2014A Phantom Model Study Using Mixed Reality"],"prefix":"10.3390","volume":"10","author":[{"given":"Johannes","family":"Hatzl","sequence":"first","affiliation":[{"name":"Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany"}]},{"given":"Daniel","family":"Henning","sequence":"additional","affiliation":[{"name":"Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany"}]},{"given":"Dittmar","family":"B\u00f6ckler","sequence":"additional","affiliation":[{"name":"Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany"}]},{"given":"Niklas","family":"Hartmann","sequence":"additional","affiliation":[{"name":"Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany"}]},{"given":"Katrin","family":"Meisenbacher","sequence":"additional","affiliation":[{"name":"Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany"}]},{"given":"Christian","family":"Uhl","sequence":"additional","affiliation":[{"name":"Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany"},{"name":"Department of Vascular Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1055\/a-1939-7686","article-title":"Mixed Reality in Vascular Surgery\u2014A Scoping Review","volume":"147","author":"Hatzl","year":"2022","journal-title":"Zentralbl Chir."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"021209","DOI":"10.1117\/1.JMI.5.2.021209","article-title":"On-the-fly augmented reality for orthopedic surgery using a multimodal fiducial","volume":"5","author":"Andress","year":"2018","journal-title":"J. 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