Gianpaolo Carrafiello1, Anna Maria Ierardi2, Ejona Duka3, Alessandro Radaelli4, Chiara Floridi5, Alessandro Bacuzzi6, Maximilian de Bucourt7, Giuseppe De Marchi8. 1. Department of Radiology, Interventional Radiology, Insubria University, Viale Borri, 57, 21100, Varese, VA, Italy. gcarraf@gmail.com. 2. Department of Radiology, Interventional Radiology, Insubria University, Viale Borri, 57, 21100, Varese, VA, Italy. amierardi@yahoo.it. 3. Department of Radiology, Interventional Radiology, Insubria University, Viale Borri, 57, 21100, Varese, VA, Italy. ejonaduka@hotmail.com. 4. Philips Healthcare, Best, The Netherlands. alessandro.radaelli@philips.com. 5. Department of Radiology, Interventional Radiology, Insubria University, Viale Borri, 57, 21100, Varese, VA, Italy. chiara.floridi@gmail.com. 6. Anaesthesia and Palliative Care, University of Insubria, Varese, Italy. alessandro.bacuzzi@ospedale.varese.it. 7. Department of Radiology, Charité - University Medicine Berlin, Berlin, Germany. maximilian.de-bucourt@charite.de. 8. Department of Radiology, Interventional Radiology, Insubria University, Viale Borri, 57, 21100, Varese, VA, Italy. giuseppedemarchi@email.it.
Abstract
BACKGROUND: This study was designed to evaluate the utility of dual phase cone beam computed tomography (DP-CBCT) and automatic vessel detection (AVD) software to guide transarterial embolization (TAE) of angiographically challenging arterial bleedings in emergency settings. METHODS: Twenty patients with an arterial bleeding at computed tomography angiography and an inconclusive identification of the bleeding vessel at the initial 2D angiographic series were included. Accuracy of DP-CBCT and AVD software were defined as the ability to detect the bleeding site and the culprit arterial bleeder, respectively. Technical success was defined as the correct positioning of the microcatheter using AVD software. Clinical success was defined as the successful embolization. Total volume of iodinated contrast medium and overall procedure time were registered. RESULTS: The bleeding site was not detected by initial angiogram in 20% of cases, while impossibility to identify the bleeding vessel was the reason for inclusion in the remaining cases. The bleeding site was detected by DP-CBCT in 19 of 20 (95%) patients; in one case CBCT-CT fusion was required. AVD software identified the culprit arterial branch in 18 of 20 (90%) cases. In two cases, vessel tracking required manual marking of the candidate arterial bleeder. Technical success was 95%. Successful embolization was achieved in all patients. Mean contrast volume injected for each patient was 77.5 ml, and mean overall procedural time was 50 min. CONCLUSIONS: C-arm CBCT and AVD software during TAE of angiographically challenging arterial bleedings is feasible and may facilitate successful embolization. Staff training in CBCT imaging and software manipulation is necessary.
BACKGROUND: This study was designed to evaluate the utility of dual phase cone beam computed tomography (DP-CBCT) and automatic vessel detection (AVD) software to guide transarterial embolization (TAE) of angiographically challenging arterial bleedings in emergency settings. METHODS: Twenty patients with an arterial bleeding at computed tomography angiography and an inconclusive identification of the bleeding vessel at the initial 2D angiographic series were included. Accuracy of DP-CBCT and AVD software were defined as the ability to detect the bleeding site and the culprit arterial bleeder, respectively. Technical success was defined as the correct positioning of the microcatheter using AVD software. Clinical success was defined as the successful embolization. Total volume of iodinated contrast medium and overall procedure time were registered. RESULTS: The bleeding site was not detected by initial angiogram in 20% of cases, while impossibility to identify the bleeding vessel was the reason for inclusion in the remaining cases. The bleeding site was detected by DP-CBCT in 19 of 20 (95%) patients; in one case CBCT-CT fusion was required. AVD software identified the culprit arterial branch in 18 of 20 (90%) cases. In two cases, vessel tracking required manual marking of the candidate arterial bleeder. Technical success was 95%. Successful embolization was achieved in all patients. Mean contrast volume injected for each patient was 77.5 ml, and mean overall procedural time was 50 min. CONCLUSIONS: C-arm CBCT and AVD software during TAE of angiographically challenging arterial bleedings is feasible and may facilitate successful embolization. Staff training in CBCT imaging and software manipulation is necessary.
Authors: H Huang; J H Siewerdsen; W Zbijewski; C R Weiss; M Unberath; T Ehtiati; A Sisniega Journal: Phys Med Biol Date: 2022-06-16 Impact factor: 4.174
Authors: Hooman Yarmohammadi; Adrian J Gonzalez-Aguirre; Majid Maybody; Etay Ziv; F Edward Boas; Joseph P Erinjeri; Constantinos T Sofocleous; Stephen B Solomon; George Getrajdman Journal: Acad Radiol Date: 2018-02-01 Impact factor: 3.173