EndoDraft® Docs

Introduction

EndoDraft® is a specialized surgical planning tool for Physician-Modified Endografts (PMEGs) and FEVAR. It allows surgeons to digitally map fenestrations onto a specific endograft template, visualize the plan in 2D and 3D, and export precise PDF templates for intraoperative use.

Installation & Updates

For security reasons, EndoDraft now comes with an installer.

• Installer (Recommended): Download EndoDraft_Setup_vX.X.X.exe and follow the installation wizard. This ensures smoother updates and creates desktop shortcuts.
• Run: Simply double-click EndoDraft.exe.
• Updates: The software includes an Automatic Update feature. On startup, it checks GitHub for new versions. If found, it can download and restart automatically.

Note: If Windows SmartScreen appears, click "More Info" -> "Run Anyway". This is normal for unsigned medical software.

Graft Parameters

Before adding fenestrations, configure the baseline graft properties in the left sidebar.

1. Patient & Dimensions

• Patient Name: Appears on the header of the exported PDF.
• Graft Diameter (mm): Crucial for accurate horizontal calculations. The software uses this to calculate the circumference ($C = d \cdot \pi$).

2. Baseline Position

Defines where the measurements start from:

• Top (0): Measurements start from the proximal edge of the fabric (top of the graph).
• Bottom (1): Measurements start from the distal edge or bifurcation flow divider (bottom of the graph).

3. Graft Type

• Tube: Standard thoracic or abdominal tube grafts.

Endograft Struts (Visual Aid)

EndoDraft can overlay the metal strut structure of specific commercial devices to help avoid fenestrations conflicting with metal parts.

Loading CT / STL Data

EndoDraft's 3D Anatomy Viewer supports loading both raw CT scans and pre-segmented 3D meshes.

• Load CT (DICOM): Select a folder containing DICOM files. The software features a Smart Folder Search that automatically finds the correct subfolder with the most files. It handles both compressed and uncompressed DICOMs securely.
• Load STL/OBJ: Load a surface mesh file (.stl, .obj) exported from 3rd party segmentation software.
• CT Threshold (HU): When a DICOM folder is loaded, use the slider to adjust the Hounsfield Unit threshold to visualize the bone and contrast-enhanced blood vessels.

Advanced Anatomy Tools

Use the sidebar controls to manipulate the loaded 3D models and visually assess the anatomy.

• MPR (Multi-Planar Reconstruction): When a DICOM is loaded, enable 2D slices to view Axial (Z), Coronal (Y), and Sagittal (X) planes simultaneously with the 3D model.
• Clipping Plane: Enable the 3D clipping plane to dynamically cut the anatomy model in half, allowing you to see inside the lumen or aneurysm sac.
• Intra-Graft View (Endoscopy): Click this toggle to fly the camera inside the graft body. This allows you to check fenestration alignment from the perspective of the guidewire.
• Model Colors: Personalize the visualization by changing the anatomy color to Ivory, Crimson, Blue, Gold, Mint, or Pink.
• Clock Guide (12h): Displays a reference ring with 12h, 3h, 6h, and 9h markers around the graft to help with orientation.
• Measure: Click the 📏 Measure tool, then select two points on the 3D model to calculate the exact Euclidean distance.

Auto-Segmentation & Centerline

EndoDraft includes a powerful voxel-based morphological engine to extract the aorta from raw CT data and generate an anatomical centerline.

Cleanup Tools

• Undo: If you make a mistake during segmentation or cutting, use the "Undo" button to restore the original, uncut anatomy.
• Select Mode: Click the "Select Mode" button, press the R key on your keyboard, and draw a rectangle with your mouse to manually select and delete specific artifacts.

3D FEVAR Planning & Graft Fitting

Once a centerline is generated, you can map target vessels directly on the 3D anatomy, and EndoDraft will calculate the complex arc lengths and clock positions for you.

1. 🎯 Start FEVAR Planning

Click the "Start FEVAR Planning" button to open the planner window.

1. Set Baseline: Click on the 3D model where you want the Y=0 baseline to be (e.g., the lowest renal artery or the flow divider). A yellow ring will appear.
2. Target Vessels: Click on the origins of the target vessels (e.g., SMA, Celiac). Red markers will appear.
3. EndoDraft calculates the true arc length (following the centerline's tortuosity) and the projected clock face angle.
4. In the floating window, you can rename vessels, adjust the fenestration hole diameter, or delete them.
5. Click Export to 2D FEVAR Planner to send these calculated coordinates to the main 2D map.

2. 🧲 Graft Fit

Click the "Graft Fit" button to automatically snap and bend the straight tubular graft model onto the generated anatomical centerline. You can use the Slide Z slider to finely adjust the cranial/caudal positioning of the graft within the aorta.

Adding Fenestrations (2D Planner)

Use the inputs in the right sidebar of the main window to define fenestrations manually.

Input Fields

1. Name: Label for the vessel (e.g., "LRA", "SMA").
2. Clock Position: Format is hhhmm (e.g., 03h30 or 12h15).
   Tip: If you type "3h30", the software autocorrects it to "03h30".
3. Distance (mm): Distance from your selected Baseline (Y-axis).
4. Diameter (mm): Size of the fenestration hole.

Click Draw Fenestration to add it to the plan.

Interactive Editing (2D)

The central 2D view is fully interactive. You can fine-tune positions using the mouse.

Drag & Drop with Measurements

Click and drag any circle to move it. While dragging, the software displays Real-time Delta measurements in red text next to the cursor:

• ΔX: Horizontal shift in mm (circumferential).
• ΔY: Vertical shift in mm (longitudinal).
• Dist: Euclidean distance from the original point.

A "Ghost" circle (dashed grey line) remains at the original position until you release the mouse, allowing precise comparisons.

Context Menu

Right-click on any fenestration to access advanced tools:

• Edit Properties: Opens a dialog to manually change name, clock position, distance, or diameter.
• Move All (Select & Place): Allows you to grab the entire plan (all fenestrations together) and shift them.
  Useful if the initial baseline registration was slightly off. Distance measurements (ΔY) are shown in real-time.
• Show/Hide Ghost Fenestrations: Toggles the visibility of the grey "original position" markers to reduce clutter.
• Delete: Removes the selected fenestration.

Undo / Redo

Mistakes happen. Use the toolbar buttons or shortcuts:

Ctrl + Z : Undo
Ctrl + Y : Redo

PDF Export

Click Generate PDF to create the printable surgical plan.

Options

• Generate 3D View PDF: Creates a second page with a snapshot of the 3D model and a data list.
• Show Axis labels: Includes mm and clock ticks on the printed PDF.

🖨️ Printing Instruction

CRITICAL: When printing the PDF, you must select "Real Size" or "Scale: 100%" in the printer dialog.
Do NOT select "Fit to page" or "Shrink to fit", as this will distort the measurements!

Laser Cutting (G-Code)

EndoDraft can generate a .gcode file for automated laser cutters (e.g., diode lasers) to cut the fenestrations into a sterile paper template.

• Enable: Check "Generate G-Code file" before clicking Generate PDF.
• Output: The file is saved in the same folder as the PDF with the _laser.gcode suffix.
• Calibration: The code assumes a standard GRBL laser setup (Units: mm). Always test on scrap paper first!

Save & Load Project

You can save your work to resume later.

• File > Save Project: Saves all parameters (patient name, graft settings, fenestrations) into a .json file.
• File > Load Project: Restores the entire state from a JSON file.

Help & Feedback

The top menu bar provides direct access to support features:

• Report a Problem: Found a bug? Use this form to send a direct message to the developers.
• Newsletter: Subscribe to receive emails about major updates and new features.
• Changelog: View the detailed list of changes for the current version.