EVARplanning è un sistema computerizzato per la configurazione predittiva dell'impianto protesico dell'aorta. Il sistema consente al chirurgo di scegliere la migliore soluzione protesica per riparare l'aneurisma, rapidamente e con maggiore accuratezza rispetto al planning manuale. Ideato e sviluppato "sul campo" a partire da una specifica esigenza del chirurgo vascolare, EVARplanning si è diffuso in tutto il mondo ed è ora utilizzato da oltre 1200 centri chirurgici. Vincitore di BioUpper 2016, il caso EVARplanning è un esempio delle potenzialità dell'uso dei dati e degli algoritmi in medicina.

1. Paolo Spada
MD, Vascular Surgeon, Humanitas Research Hospital, Milan
EVARplanning Founder
Introducing
Data driven innovation in chirurgia:
il caso EVARplanning

4. Biotecnologie orientate alle scienze mediche
• Prodotti farmaceutici
• Medicina rigenerativa
• Medicina personalizzata
• Terapia genica
• Immunoterapia
• Prodotti nutraceutici
Strumenti digitali al servizio della salute
e dispositivi medicali
• Rilevazione parametri vitali/sintomi
• Dispositivi terapeutici
• Dispositivi per la diagnostica
Servizi orientati al paziente o alla sanità
• Gestione del servizio socio-sanitario
• Erogazione del servizio socio-sanitario
• Servizio di informazione/formazione al paziente

7. Aortic Aneurysm

8. EVAR
EndoVascular Aortic Repair

9. Instructions for use
(IFU) = limits of use

12. 20% endoleaks after EVAR
American College of Surgeons, January 2016

13. Algorithm
design
App
development
Website
Free web app
Registered
members

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400
600
800
1000 mag-14
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Members

15. 1.285 members, 10% global EVAR surgeons, 296 plannings/month (Google Analytics)
EVARplanning sessions last 12 months

17. Review of 407 cases

18. Software for vascular imaging and sizing

21. Main body
16F / 6.2 mm OD
Landing 180 mm
distal common iliac
Sealing 55 mm
Left leg
12F / 5 mm OD
Landing 180 mm
distal common iliac
Sealing 55 mm
PXC121400RLT261218
Gate
70 mm
Overlap
30 mm

22. Main body
16F / 6.2 mm OD
Landing 180 mm
distal common iliac
Sealing 55 mm
Left leg
12F / 5 mm OD
Landing 180 mm
distal common iliac
Sealing 55 mm
PXC121400RLT261218
Oversize
Neck 18%
Bifurcation 38%
Left iliac 20%

23. Francesco Migliavacca
full professor
Giancarlo Pennati
full professor
Gabriele Dubini
full professor
EVARplanning development plan
Mechanical predictive analysis and machine learning
Politecnico di Milano,
Laboratory of Biological Stucture Mechanics
Algorithm and 3D modeling software development
CINECA non-profit consortium of universities
Cloud-based web platform
Wezen technologies

26. Individual
member
surgeon
CT upload
from CD
or local
drive
CT viewer
and
automatic
sizing
Endograft
selection
and
planning
Online
sharing of
CT and
planning
Endograft
company
specialist
Quick
endograft
order
Case
assignement
to endograft
company
HIPAA compliance for anonymization of data
The next
EVARplanning platform
CE – Software As a Medical Device (SAMD)
Algorithm Copyright © P. Spada, December 1 2014

27. Hospital
member
surgeons
Other
hospitals
CT upload
from
hosp.
PACS
CT upload
from
external user
Case
sharing or
referral
CT upload
from CD
or local
drive
CT viewer
and
automatic
sizing
Endograft
selection
and
planning
Online
sharing of
CT and
planning
Case
assignement
to endograft
company
Quick
endograft
order
Case not assigned
(unlimited upload
for hospital users)
Endograft
company
specialist
Individual
member
surgeon
CT upload
from CD
or local
drive
*Not-assigned cases are
cancelled after 60 days.
Upload limitation based on
not-assigned/assigned cases ratio.
Case not assigned
(limited upload for
individual user)*

28. Follow up
CT upload
Mechanical
Analysis
Rendering
Predictive
planning
New case
Implant
Mechanical
analysis
Outcome
detection
Rendering
algorithm
Configuration
algorithm
DATA

29. Benefits SurgeonsPatients

30. Hospitals Endograft CompaniesBenefits

31. Start from techs
Algorithms: yes we can
Data = EBM = Outcomes & QoL
Leverage communities
Niche is beautiful

32. Question time!