0498: The value of image fusion in coronary angiography for the detection of coronary artery bypass graft

Abstract

The coronary angiography among patients with coronary artery bypass graft (CABG) are more complex procedures with more X-ray exposure, longer compared to conventional coronary angiography. Image fusion is a new technology allowing a fusion in real-time of a 3D model obtained by reconstruction of computed tomography (CT) images with fluoroscopic images. To evaluate the contribution of image fusion in coronary angiography for the detection of CABG. A prospective study over 9 months, single center comparing the use of image fusion to conventional coronary angiography. All patients coming for angiographic control of CABG were included in the study. Patients who had previously (for another indication) a chest CT with injection of contrast media were the fusion image group, patients without prior injected chest CT constituted the control group. For patients in the fusion group, the aorta, the CABG, sternotomy sutures, the bronchi and a vertebra were reconstructed in 3D from CT acquisitions and these images were incorporated in real-time on fluoroscopic images. The following parameters were reported in both groups and compared: search time of CABG, procedure time, X-Ray exposure and the amount of contrast. 59 patients were included, 13 in the fusion image group, 46 in the control group. There were not significant differences between the 2 groups in terms of general characteristics patients and procedures. The search time of CABG was significantly shorter in the fusion group of images in the control group (16.04 min±13.2 min vs 6.4 min±4.7 min, p=0.002), as well as procedure time (31.5 min±15.2 min vs 19.4 min± 6.8 min, p = 0.007), fluoroscopy time (14.76 min±8.3 min vs 9.3 min±4.2 min, p = 0.04), Air KERMA (822.9 mGy±475.5 mGy vs 569.1 mGy±242.4 mGy, p = 0.01) and amount of iodinated contrast (121 cc ± 43.5 cc vs 88.2 cc±30.8 cc, p = 0.01). 3D reconstruction of CABG from CT with real-time fusion on coronary angiography images may shorten the search time of CABG, procedure time, X-Ray exposure and the use of iodinated contrast compared to standard coronary angiography for diagnostic purposes in patients with CABG. Abstract 0498 – Figure: 3D picture merged with the real-time fluoroscopic