Combined visualization in endovascular treatment lower limb arteries pathology
M V Agarkov1,2, K L Kozlov2,3, O B Gertsog1
1Gusev Central District Hospital, 238051, Gusev, Kaliningrad Region, Russian Federation.
Objective:
The purpose of the study was to investigate the effect of intraoperative 3D fusion imaging on the time of surgery, radiation dose and volume of contrast medium during endovascular treatment of peripheral artery disease.
Patients And Methods:
This prospective, single-center, randomized comparative 30-month trial included a total of 395 patients with lesions of aortofemoral, femoropopliteal segments and tibial arteries. They were all candidates for endovascular revascularization and divided into two groups. The Study Group patients (n=197) underwent operations with combined 3D fusion navigation, whereas the Control Group patients (n=198) were operated on without 3D-imaging. We compared the operation time, radiation dose, and contrast medium volume, followed by analyzing the learning curve.
Results:
The operation time in the Study Group amounted to 62.53 (10 195) min versus 87.82 (6 340) min in the Control Group (p<0.05), with a time reduction of 29%. The volume of contrast medium in the Study Group amounted to 91.19 (10 850) vs 168.05 (20 440) ml in the Control Group (p<0.05), with a decrease of the contrast medium used amounting to 46.6%. The radiation dose in the Study Group was 245.25 (9 2756) vs 472.92 (5 3987) mGy in the Control Group (p<0.05), thus showing a reduction by 63.38%. Stratification of the group of combined navigation into 4 subgroups according to the dates of the procedure demonstrated no influence of the potential learning curve on the parameters examined.
Conclusion:
The obtained findings demonstrated a significant reduction in the contrast volume (p<0.05), time of surgery (p<0.05) and radiation dose (p<0.05) during endovascular treatment of obliterating sclerosis of lower limb vessels using the technology of combined navigation. These results highlight the potential benefits of routine use of 3D-fusion hybrid imaging when performing endovascular revascularization in patients with PAD.
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