iSizing in action: For everyday clinical practice
EVAR planning has traditionally relied heavily on manual measurements, repeated checks, and the subjective interpretation of complex CT imaging. This case demonstrates how Dr. Fernando Gallardo performed EVAR sizing at Hospital Quironsalud Marbella using PlanOp iSizing, PrediSurge’s fully automated EVAR sizing and planning software. The result is a clear illustration of how iSizing reduces the planning time while enhancing precision, consistency, and clinician confidence while giving full control to surgeon's.
A clinical scenario that mirrors everyday practice
The Gallardo case reflects a typical abdominal aortic aneurysm (AAA) presentation: a challenging anatomy requiring accurate neck evaluation, careful iliac assessment, and reliable device planning. In such cases, the margin for error is small—oversizing, undersizing, or misinterpreting thrombus involvement may directly affect procedural success. iSizing is designed precisely for this type of scenario, offering clinicians a workflow that integrates seamlessly into daily practice without changing their clinical decision‑making principles.
From CT scan to insightful visualization with automated segmentation
Here, you can just upload the CT scan, and with a single click, iSizing automatically segments the anatomy and visualises it in the MPR Viewer, allowing you to seamlessly analyse between axial, coronal, sagittal, and 3D views.
One of the standout capabilities of iSizing is the fully automated segmentation including Flow lumen, Thrombus and calcification
In the Dr. Fernando's case, this segmentation removed the guesswork and repetition typically involved in manual boundary tracing. Having thrombus included in diameter estimations—and calcifications excluded—ensures that the output reflects clinically meaningful measurements, not raw geometric approximations. This step alone significantly reduces variability between operators, a key improvement for
- Vascular surgeons working on the same case
- Institutions aiming for standardized EVAR empowering clinical operations.
Automated, Consistent, Reproducible Sizing — 50 Measures/ Patient
iSizing generated a complete dataset of the patient’s aorto‑iliac anatomy: From Proximal neck diameters to External Illiac access diameters including flow lumen, thrombus and calcifications.
Beyond the raw diameters, iSizing also considers
- Maximum Thrombus thickness: 2.2mm
- Circumferential Thrombus involvement: 31%
Every cross‑section is analysed using 100 radius measurements per slice—this provides a robust, reproducible view of both anatomy and thrombus distribution. In Dr. Fernando's case, this allowed the clinician to focus on interpreting anatomy and defining an appropriate proximal sealing strategy, rather than spending time on repetitive manual measurements.
Planning Assistant: Interactive 3D device planning
The hallmark of the Dr. Fernando's planning session was the interactive 3D simulation. Within isizing, the clinician selected the appropriate graft components and visualized their deployment:
- Main body selection
- Ipsilateral and contralateral limb extensions
- A right‑side introduction approach
The ability to interact with the device in real time—rotating, adjusting, aligning—creates a rehearsal of the actual intervention. Overlap zones, limb alignment, and access feasibility become visually intuitive rather than abstract.
Shareable Report for Team Communication
After automated sizing, intuitive planning, iSizing generated a structured report containing both sizing measurements and planning report with device configuration, visuals and anatomical notes.
This document can be shared with colleagues, Device Manufacturers, or saved for records. Providing autonomy and collaboration and control over the everyday clinical practice.