The Use of Advanced Three-Dimensional Computed Tomography During Simple and Complex Endovascular Aortic Aneurysm...

Area of Science:

• Vascular Surgery
• Medical Imaging
• Interventional Radiology

Background:

• Endovascular aneurysm repair (EVAR) relies heavily on imaging for planning and execution.
• Current EVAR methods involve contrast and radiation exposure for patients and operators.
• Advancements aim to integrate pre-operative and intra-operative imaging for enhanced EVAR efficiency and accuracy.

Purpose of the Study:

• To investigate the efficacy and safety of the Cydar 3D imaging system in EVAR compared to conventional techniques.
• To assess the impact of Cydar 3D imaging on patient and operator outcomes.

Main Methods:

• Retrospective review of 138 EVAR patients (2019-2023) at a single center.
• Comparison of 27 cases using Cydar 3D imaging versus 111 cases without.
• 1-to-1 propensity score matching created a cohort of 54 patients (27 per group).
• Analysis of outcomes including length of stay, contrast volume, fluoroscopy time, procedure length, mortality, and blood loss.

Main Results:

• No statistically significant differences were observed in length of stay, aneurysm size, contrast volume, fluoroscopy time, procedure length, or blood loss between the groups.
• A statistically significant increase in reintervention for endoleaks was noted in the Cydar 3D imaging group (P=0.043).
• A subanalysis revealed a 15% reduction in contrast volume for physician-modified EVARs using Cydar 3D imaging.

Conclusions:

• The Cydar 3D imaging system did not show significant differences in standard EVAR outcomes in this study.
• A notable reduction in contrast volume was observed in physician-modified EVARs.
• Further research is required to fully ascertain the benefits of Cydar 3D imaging in EVAR procedures.