A M Sailer1, M W de Haan2, A G Peppelenbosch3, M J Jacobs3, J E Wildberger2, G W H Schurink3. 1. Department of Radiology, Maastricht University Medical Centre, Maastricht, The Netherlands. Electronic address: anni.sailer@mumc.nl. 2. Department of Radiology, Maastricht University Medical Centre, Maastricht, The Netherlands. 3. Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Abstract
OBJECTIVES: To evaluate the effect of intraoperative guidance by means of live fluoroscopy image fusion with computed tomography angiography (CTA) on iodinated contrast material volume, procedure time, and fluoroscopy time in endovascular thoraco-abdominal aortic repair. METHODS: CTA with fluoroscopy image fusion road-mapping was prospectively evaluated in patients with complex aortic aneurysms who underwent fenestrated and/or branched endovascular repair (FEVAR/BEVAR). Total iodinated contrast material volume, overall procedure time, and fluoroscopy time were compared between the fusion group (n = 31) and case controls (n = 31). Reasons for potential fusion image inaccuracy were analyzed. RESULTS: Fusion imaging was feasible in all patients. Fusion image road-mapping was used for navigation and positioning of the devices and catheter guidance during access to target vessels. Iodinated contrast material volume and procedure time were significantly lower in the fusion group than in case controls (159 mL [95% CI 132-186 mL] vs. 199 mL [95% CI 170-229 mL], p = .037 and 5.2 hours [95% CI 4.5-5.9 hours] vs. 6.3 hours (95% CI 5.4-7.2 hours), p = .022). No significant differences in fluoroscopy time were observed (p = .38). Respiration-related vessel displacement, vessel elongation, and displacement by stiff devices as well as patient movement were identified as reasons for fusion image inaccuracy. CONCLUSION: Image fusion guidance provides added value in complex endovascular interventions. The technology significantly reduces iodinated contrast material dose and procedure time.
OBJECTIVES: To evaluate the effect of intraoperative guidance by means of live fluoroscopy image fusion with computed tomography angiography (CTA) on iodinated contrast material volume, procedure time, and fluoroscopy time in endovascular thoraco-abdominal aortic repair. METHODS: CTA with fluoroscopy image fusion road-mapping was prospectively evaluated in patients with complex aortic aneurysms who underwent fenestrated and/or branched endovascular repair (FEVAR/BEVAR). Total iodinated contrast material volume, overall procedure time, and fluoroscopy time were compared between the fusion group (n = 31) and case controls (n = 31). Reasons for potential fusion image inaccuracy were analyzed. RESULTS: Fusion imaging was feasible in all patients. Fusion image road-mapping was used for navigation and positioning of the devices and catheter guidance during access to target vessels. Iodinated contrast material volume and procedure time were significantly lower in the fusion group than in case controls (159 mL [95% CI 132-186 mL] vs. 199 mL [95% CI 170-229 mL], p = .037 and 5.2 hours [95% CI 4.5-5.9 hours] vs. 6.3 hours (95% CI 5.4-7.2 hours), p = .022). No significant differences in fluoroscopy time were observed (p = .38). Respiration-related vessel displacement, vessel elongation, and displacement by stiff devices as well as patient movement were identified as reasons for fusion image inaccuracy. CONCLUSION: Image fusion guidance provides added value in complex endovascular interventions. The technology significantly reduces iodinated contrast material dose and procedure time.
Authors: A Feddal; S Escalard; F Delvoye; R Fahed; J P Desilles; K Zuber; H Redjem; J S Savatovsky; G Ciccio; S Smajda; M Ben Maacha; M Mazighi; M Piotin; R Blanc Journal: AJNR Am J Neuroradiol Date: 2020-08-20 Impact factor: 3.825
Authors: Anna M Sailer; Patricia J Nelemans; Camille van Berlo; Ozan Yazar; Michiel W de Haan; Dominik Fleischmann; Geert Willem H Schurink Journal: Eur Radiol Date: 2015-10-02 Impact factor: 5.315
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Authors: M M Sieren; C Schareck; M Kaschwich; M Horn; F Matysiak; E Stahlberg; F Wegner; T H Oechtering; J Barkhausen; J Goltz Journal: CVIR Endovasc Date: 2021-06-14
Authors: Seline R Goudeketting; Stefan G H Heinen; Michiel W de Haan; Anna M Sailer; Daniel A F van den Heuvel; Marco J van Strijen; Jean-Paul P M de Vries Journal: Trials Date: 2018-11-01 Impact factor: 2.279