AUTHOR=Dinc Rasit , Ardic Nurittin 

TITLE=AI-driven decision making for intravascular device selection in aortic disease. Current insights and prospects

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1585299

DOI=10.3389/fcvm.2025.1585299

ISSN=2297-055X

ABSTRACT=Abdominal and thoracic aortic repairs increasingly rely on endovascular solutions, but device selection in anatomically complex cases remains prone to error due to measurement variability, tortuosity, short/angulated necks, and heterogeneous post-EVAR evolution. This article focuses on artificial intelligence (AI) tools that support intravascular device selection and planning, particularly in abdominal and thoracic aortic aneurysms, and type B dissection scenarios where endovascular repair (EVAR/TEVAR) is applicable. We synthesize evidence on (i) automated centerline extraction and 3D measurements that standardize sizing; (ii) risk models that predict inadequate sealing or endoleakage to guide oversizing and landing zone strategy; and (iii) procedural environment “augmented intelligence” maps and extended reality modules that operationalize device selections in the laboratory. We summarize commercial and research-level systems, clinical readiness, and regulatory status, and outline validation, explainability, and bias considerations. While current evidence-based workflows achieve excellent results, targeted AI components reduce variability and can support consistent device decisions across complex anatomies. Prospective, multicenter validation is needed before routine implementation; for now, AI should be viewed as a complement, rather than a replacement, to established EVAR/TEVAR planning and oversight.