DynaCT during EVAR – A Comparison with Multidetector CT

Eide, K.R.; Ødegård, Asbjørn; Myhre, Hans O.; Lydersen, Stian; Hatlinghus, Staal; Haraldseth, Olav

doi:10.1016/j.ejvs.2008.09.017

Cited by 42 publications

(30 citation statements)

References 21 publications

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“…As has been previously demonstrated that diameter measurements on CBCT and MDCT showed comparable outcomes, 3,10 results from this study support these findings. While not applicable to current fenestrated endografting, this technology may prove useful in the on-table planning and sizing of patients undergoing endovascular aneurysm repair (EVAR), 1,2 particularly in the setting of ruptured abdominal aortic aneurysms.…”

Section: Discussionsupporting

confidence: 93%

“…Preliminary experience has demonstrated its potential utility in pre-and postdeployment scenarios. [1][2][3][4][5] One of the most potentially useful applications of CBCT is intraoperatively to guide the performance of fluoroscopy-driven procedures using fusion of CT images and fluoroscopy, similar to traditional "roadmapping." Intraoperative CBCT images can be registered, or fused, with preoperative MDCT allowing the MDCT image to be superimposed on the live fluoroscopic image.…”

mentioning

confidence: 99%

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Intraoperative C-arm cone-beam computed tomography in fenestrated/branched aortic endografting

Dijkstra

Eagleton

Greenberg

et al. 2011

Journal of Vascular Surgery

162

110

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CBCT is a valuable addition to complicated aortic interventions such as FEVAR. Intraoperative use utilizing fusion imaging limits contrast dosage and postdeployment CBCT is of sufficient quality to evaluate successful aneurysm exclusion and for detection of early complications after FEVAR. With the information we are able to obtain from the CBCT at the completion of the FEVAR, we can intervene on problems earlier and potentially decrease the subsequent need for reintervention.

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Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 99%

Intraoperative C-arm cone-beam computed tomography in fenestrated/branched aortic endografting

Dijkstra

Eagleton

Greenberg

et al. 2011

Journal of Vascular Surgery

162

110

View full text Add to dashboard Cite

show abstract

“…To find the optimal fluoroscopic implant view, various imaging modalities such as multidetector computed tomography (MDCT) [3][4][5] and repeated aortic root angiograms from different angles have been used. Three-dimensional angiographic reconstructions (3DA) of the aortic root captured from rotational C-arm fluoroscopic images 6 have been evaluated in different interventional settings, for example, in endovascular aortic aneurysm repair 7,8 and catheter ablation procedures. 9,10 However, the value of this method for TAVR is not yet established.…”

mentioning

confidence: 99%

Prediction of Optimal Deployment Projection for Transcatheter Aortic Valve Replacement

Binder

Leipsic

Wood

et al. 2012

Circ: Cardiovascular Interventions

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Background-Identifying the optimal fluoroscopic projection of the aortic valve is important for successful transcatheter aortic valve replacement (TAVR). Various imaging modalities, including multidetector computed tomography (MDCT), have been proposed for prediction of the optimal deployment projection. We evaluated a method that provides 3-dimensional angiographic reconstructions (3DA) of the aortic root for prediction of the optimal deployment angle and compared it with MDCT. Methods and Results-Forty patients undergoing transfemoral TAVR at St Paul's Hospital, Vancouver, Canada, were evaluated. All underwent preimplant 3DA and 68% underwent preimplant MDCT. Three-dimensional angiographic reconstructions were generated from images of a C-arm rotational aortic root angiogram during breath-hold, rapid ventricular pacing, and injection of 32 mL contrast medium at 8 mL/s. Two independent operators prospectively predicted perpendicular valve projections. The implant angle was chosen at the discretion of the physician performing TAVR. The angles from 3DA, from MDCT, the implant angle, and the postdeployment perpendicular prosthesis view were compared. The shortest distance from the postdeployment perpendicular prosthesis projection to the regression line of predicted perpendicular projections was calculated. All but 1 patient had adequate image quality for reproducible angle predictions. There was a significant correlation between 3DA and MDCT for prediction of perpendicular valve projections (rϭ0.682, PϽ0.001). Deviation from the regression line of predicted angles to the postdeployment prosthesis view was 5.1Ϯ4.6°for 3DA and 7.9Ϯ4.9°for MDCT (Pϭ0.01). Conclusions-Three-dimensional angiographic reconstructions and MDCT are safe, practical, and accurate imaging modalities for identifying the optimal perpendicular valve deployment projection during TAVR. (Circ Cardiovasc Interv. 2012;5:247-252.)

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“…The images are reconstructed on a workstation (Leonardo, Siemens, Germany) and can be visualized in the OR. This CBCT imaging modality has some quality limitations compared to regular multislice CT, 8 but the intraoperative imaging possibilities provide great experimental possibilities (and patient logistics).…”

Section: Computed Tomographymentioning

confidence: 99%

Development of a Multimodal Tumor Model for Porcine Liver

Rethy

Langø

Aasland

et al. 2010

Journal of Gastrointestinal Surgery

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In our efforts to develop a guidance system for laparoscopic liver surgery, we are working towards a live animal tumor model. The objective of this study was to establish the tumor model for live porcine liver, visible on both computed tomography (CT) and ultrasound images. The tumor model was created by injecting a mixture of agarose, sephadex, and glycerol. Together with water, the mixture was heated to bring its components into solution. Once heating was complete, methylthionine chloride and CT contrast were added. Using laparoscopic ultrasound guidance, the tumor model mixture was injected into in vivo porcine liver. The resulting model tumors were radiolucent, visible on both CT and conventional X-ray. They appeared as hyperechoic lesions on ultrasound images. Compared to the CT images, the model tumors in the ultrasound images showed good correspondence in size. We conclude that our tumor model, due to its clearly identifiable nature on multiple imaging modalities, is a valuable tool for further studies on laparoscopic ultrasound (2D and 3D) and navigated ultrasound in laparoscopic surgery of the liver and other organs in a pre-clinical set-up.

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DynaCT during EVAR – A Comparison with Multidetector CT

Abstract: Our findings indicate that on-table DynaCT are of sufficient quality to give relevant information of arterial measurements, needed in endovascular repair of infrarenal aortic aneurysms.

Cited by 42 publications

References 21 publications

Intraoperative C-arm cone-beam computed tomography in fenestrated/branched aortic endografting

Intraoperative C-arm cone-beam computed tomography in fenestrated/branched aortic endografting

Prediction of Optimal Deployment Projection for Transcatheter Aortic Valve Replacement

Development of a Multimodal Tumor Model for Porcine Liver

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