Seline R Goudeketting1, Stefan G H Heinen1, Çağdaş Ünlü2, Daniel A F van den Heuvel3, Jean-Paul P M de Vries1, Marco J van Strijen3, Anna M Sailer4,5. 1. 1 Department of Vascular Surgery, St Antonius Hospital, Nieuwegein, the Netherlands. 2. 2 Department of Vascular Surgery, Noordwest Hospital, Alkmaar, the Netherlands. 3. 3 Department of Interventional Radiology, St Antonius Hospital, Nieuwegein, the Netherlands. 4. 4 Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA. 5. 5 Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands.
Abstract
PURPOSE: To systematically review and meta-analyze the added value of 3-dimensional (3D) image fusion technology in endovascular aortic repair for its potential to reduce contrast media volume, radiation dose, procedure time, and fluoroscopy time. METHODS: Electronic databases were systematically searched for studies published between January 2010 and March 2016 that included a control group describing 3D fusion imaging in endovascular aortic procedures. Two independent reviewers assessed the methodological quality of the included studies and extracted data on iodinated contrast volume, radiation dose, procedure time, and fluoroscopy time. The contrast use for standard and complex endovascular aortic repairs (fenestrated, branched, and chimney) were pooled using a random-effects model; outcomes are reported as the mean difference with 95% confidence intervals (CIs). RESULTS: Seven studies, 5 retrospective and 2 prospective, involving 921 patients were selected for analysis. The methodological quality of the studies was moderate (median 17, range 15-18). The use of fusion imaging led to an estimated mean reduction in iodinated contrast of 40.1 mL (95% CI 16.4 to 63.7, p=0.002) for standard procedures and a mean 70.7 mL (95% CI 44.8 to 96.6, p<0.001) for complex repairs. Secondary outcome measures were not pooled because of potential bias in nonrandomized data, but radiation doses, procedure times, and fluoroscopy times were lower, although not always significantly, in the fusion group in 6 of the 7 studies. CONCLUSION: Compared with the control group, 3D fusion imaging is associated with a significant reduction in the volume of contrast employed for standard and complex endovascular aortic procedures, which can be particularly important in patients with renal failure. Radiation doses, procedure times, and fluoroscopy times were reduced when 3D fusion was used.
PURPOSE: To systematically review and meta-analyze the added value of 3-dimensional (3D) image fusion technology in endovascular aortic repair for its potential to reduce contrast media volume, radiation dose, procedure time, and fluoroscopy time. METHODS: Electronic databases were systematically searched for studies published between January 2010 and March 2016 that included a control group describing 3D fusion imaging in endovascular aortic procedures. Two independent reviewers assessed the methodological quality of the included studies and extracted data on iodinated contrast volume, radiation dose, procedure time, and fluoroscopy time. The contrast use for standard and complex endovascular aortic repairs (fenestrated, branched, and chimney) were pooled using a random-effects model; outcomes are reported as the mean difference with 95% confidence intervals (CIs). RESULTS: Seven studies, 5 retrospective and 2 prospective, involving 921 patients were selected for analysis. The methodological quality of the studies was moderate (median 17, range 15-18). The use of fusion imaging led to an estimated mean reduction in iodinated contrast of 40.1 mL (95% CI 16.4 to 63.7, p=0.002) for standard procedures and a mean 70.7 mL (95% CI 44.8 to 96.6, p<0.001) for complex repairs. Secondary outcome measures were not pooled because of potential bias in nonrandomized data, but radiation doses, procedure times, and fluoroscopy times were lower, although not always significantly, in the fusion group in 6 of the 7 studies. CONCLUSION: Compared with the control group, 3D fusion imaging is associated with a significant reduction in the volume of contrast employed for standard and complex endovascular aortic procedures, which can be particularly important in patients with renal failure. Radiation doses, procedure times, and fluoroscopy times were reduced when 3D fusion was used.
Authors: Marloes M Jansen; Merel van der Stelt; Stefan P M Smorenburg; Cornelis H Slump; Joost A van Herwaarden; Constantijn E V B Hazenberg Journal: Quant Imaging Med Surg Date: 2021-09
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
Authors: Sabrina A N Doelare; Stefan P M Smorenburg; Theodorus G van Schaik; Jan D Blankensteijn; Willem Wisselink; Johanna H Nederhoed; Rutger J Lely; Arjan W J Hoksbergen; Kak Khee Yeung Journal: J Endovasc Ther Date: 2020-09-23 Impact factor: 3.487