Meta-analysis of Cumulative Radiation Duration and Dose During EVAR Using Mobile, Fixed, or Fixed/3D Fusion C-Arms

Abstract

For equivalent fluoroscopy times, the use of a fixed C-arm in noncomplex procedures leads to higher patient radiation doses compared to a mobile C-arm. Complex procedures, which are predominantly performed using fixed C-arms, are associated with the highest radiation dose per intervention. Using fixed C-arms combined with 3D-IF techniques during complex cases might seem an adequate method to compensate for the higher radiation doses measured when a fixed C-arm is used.

Use of Synchrotron Radiation to Accurately Assess Cross-Sectional Area Reduction of the Aortic Branch Ostia Caused by Suprarenal Stent Wires

“…However, repeated CT scans expose patients to high cumulative radiation doses and nephrotoxic intravenous contrast medium. 44,45 This has raised serious concerns. To address this issue, low-dose CTA protocols have been reported to show the feasibility of reducing both radiation dose (reduce tube voltage from 120 to 100 or 80 kV) and contrast volume (lower contrast medium to 30 mL) while capturing diagnostic-quality images.…”

Fusion Imaging for EVAR with Mobile C-arm

“…This makes it possible to navigate the vascular tree without necessarily having to use iodinated contrast agent. An increasing number of studies are reporting on the use of fusion imaging in aortic endovascular procedures and its benefits (1)(2)(3)(4)(5).…”

Endoanchors under 3D image fusion for a type IA endoleak after EVAR

“…Today's hybrid operating rooms (HOR) facilitate complex and very accurate interventions with advanced radiographic imaging, such as 3‐dimensional image fusion (3D‐IF) of preoperative computed tomography (CT) images with intraoperative fluoroscopy images . The 3D volume rendering (VR) image overlay fused with 2D fluoroscopy enabled procedure performance with constant road mapping of the aortic wall and the origin of the aortic branches to improve intravascular orientation.…”