Feasibility of three-dimensional fusion imaging with multimodality roadmap system during endovascular aortic repair

Autor: Koichi Miyake, Suguru Shiraya, Atsuhisa Ishida, Hidenori Yoshitaka, Taichi Sakaguchi, Genta Chikazawa, Arudo Hiraoka
Rok vydání: 2017
Předmět:
Male
Time Factors
Databases
Factual
Computed Tomography Angiography
medicine.medical_treatment
Contrast Media
030204 cardiovascular system & hematology
030230 surgery
Endovascular aneurysm repair
Multimodal Imaging
Aortic aneurysm
0302 clinical medicine
Postoperative Complications
Risk Factors
Medicine
Fluoroscopy
Computed tomography angiography
Aged
80 and over
medicine.diagnostic_test
Endovascular Procedures
Middle Aged
Radiation Exposure
Aortic Aneurysm
Treatment Outcome
Surgery
Computer-Assisted
Predictive value of tests
Radiographic Image Interpretation
Computer-Assisted
Female
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
Aortography
Operative Time
Radiation Dosage
03 medical and health sciences
Blood Vessel Prosthesis Implantation
Imaging
Three-Dimensional
Predictive Value of Tests
Humans
Aged
Retrospective Studies
business.industry
Retrospective cohort study
medicine.disease
Surgery
Iopamidol
Contrast medium
Feasibility Studies
business
Zdroj: Journal of vascular surgery. 68(4)
ISSN: 1097-6809
Popis: Objective Endovascular procedures for aortic aneurysm repair have become widely accepted as safe and effective surgical options. We investigated the efficacy of the multimodality roadmap (MMR) system with biplane fluoroscopy to attempt to reduce the use of contrast medium and exposure to radiation during surgery. Methods We retrospectively reviewed 263 consecutive cases with elective endovascular aneurysm repair (EVAR) and thoracic endovascular aortic repair (TEVAR). Patients were categorized into two groups, with and without introduction of the MMR system, which was applied in 164 patients (62.4%). The MMR− group included 62 EVAR and 37 TEVAR cases, and the MMR+ group consisted of 81 EVAR and 83 TEVAR cases. Radiation dose, contrast medium use, and complications were compared between the MMR− and MMR+ groups in the respective EVAR and TEVAR groups. Results There was a significantly lower amount of contrast medium use in the MMR+ group compared with the MMR− group in EVAR (32.9 ± 10.6 g and 28.2 ± 10.2 g; P = .009) and TEVAR (31.7 ± 11.5 g and 26.9 ± 7.8 g; P = .009). In addition, significantly lower radiation exposure was observed in the MMR+ group of TEVAR (872 ± 623 mGy vs 638 ± 463 mGy; P = .033). The operative time of the MMR+ group was significantly shorter for patients with TEVAR compared with the MMR− group (96.4 ± 27.0 minutes vs 86.2 ± 23.9 minutes; P = .023). The incidence of access injury and other complications was similar in both EVAR and TEVAR groups. Conclusions The MMR system with three-dimensional fusion imaging can reduce the contrast medium dose in EVAR and the exposure to contrast medium and radiation in TEVAR.
Databáze: OpenAIRE
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