Fusion Imaging for EVAR with Mobile C-arm.

Area of Science:

• Medical Imaging
• Endovascular Surgery
• Interventional Radiology

Background:

• Fusion imaging, crucial for endovascular navigation, is typically confined to specialized hybrid operating rooms.
• This study investigates the feasibility of employing fusion imaging with a mobile C-arm in conventional operating rooms.

Purpose of the Study:

• To evaluate the feasibility and clinical utility of fusion imaging with a mobile C-arm and angionavigation station in a conventional operating room setting.
• To assess the impact on procedure efficiency and resource utilization for endovascular aortic repair (EVAR).

Main Methods:

• A prospective study involving 54 patients undergoing aortic stent graft procedures using a mobile C-arm and angionavigation station.
• Preoperative 3D CT/perioperative 2D fluoroscopy fusion imaging was performed with automatic registration.
• Outcomes including contrast dose, operation time, and fluoroscopy time were compared to a control group.

Main Results:

• Fusion imaging achieved a 95.5% success rate (170 out of 178 registrations).
• In EVAR procedures, fusion imaging significantly reduced contrast agent volume (42.3 vs. 81.2 mL) and operation time (114 vs. 140.8 min) compared to controls.
• No significant difference in fluoroscopy time was observed between the groups.

Conclusions:

• Fusion imaging is feasible in conventional operating rooms using a mobile C-arm, providing an alternative to hybrid rooms.
• The angionavigation system shows potential to facilitate EVAR procedures, with reduced contrast and shorter operation times.
• Further randomized studies are warranted to confirm clinical benefits.