Background
Fusion imaging makes it possible to improve endovascular procedures and is mainly
used in hybrid rooms for aortic procedures. The objective of this study was to evaluate
the feasibility of fusion imaging for femoropopliteal endovascular procedures with
a mobile flat plane sensor and dedicated software to assist endovascular navigation.
Materials and methods
Between May and December 2017, 41 patients requiring femoropopliteal endovascular
revascularization were included. Interventions were carried out in a conventional
surgical room equipped with a mobile plane sensor (Cios Alpha, Siemens). The numerical
video stream was transmitted to an angionavigation station (EndoNaut (EN), Therenva).
The software created an osseous and arterial panorama of the treated limb from the
angiographies carried out at the beginning of procedure. After each displacement of
the table, the software relocated the current image on the osseous panorama, with
2D-2D resetting, and amalgamated the mask of the arterial panorama. The success rates
of creation of osseous and arterial panorama and the success of relocation were evaluated.
The data concerning irradiation, the volume of contrast (VC) injected, and operative
times were recorded.
Results
Osseous panoramas could be automatically generated for the 41 procedures, without
manual adjustment in 33 cases (80.5%). About 35 relocations based on a 2D-2D resetting
could be obtained in the 41 procedures, with a success rate of 85%. The causes of
failure were a change in table height or arch angulation. The average duration of
intervention was 74.5 min. The irradiation parameters were duration of fluoroscopy
17.8 ± 13.1 min, air kerma 80.5 ± 68.4 mGy, and dose area product 2140 ± 1599 μGy m2. The average VC was 24.5 ± 14 mL.
Conclusions
This preliminary study showed that fusion imaging is possible in a nonhybrid room
for peripheral procedures. Imagery of mobile C-arms can be improved for femoropopliteal
endovascular procedures without heavy equipment. These imagery tools bring an operative
comfort and could probably reduce irradiation and the injected VC. The clinical benefit
must be evaluated in more patients in a randomized comparative study with a rigorous
methodology.
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Article info
Publication history
Published online: September 02, 2020
Accepted:
July 27,
2020
Received:
February 2,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
