Abstract No. 242 - Comparing 2d angiography, 3D rotational angiography, and pre-procedural CT image fusion with 2d fluoroscopy for endovascular repair of thoraco-abdominal aortic aneurysm

Abstract

Purpose To evaluate the feasibility of pre-procedural arterial phase computed tomography image fusion with intra-procedural fluoroscopy (or Image fusion: IF) road-mapping in endovascular repair of thoraco-abdominal aortic aneurysm (EVRTAAA) compared to current road-mapping methods (2D and 3D angiographies) in terms of x-ray exposure, injected contrast volume, and procedure time. Materials and Methods Single-institution prospective study (Internal institute approved), on 37 patients, informed written consent provided, and treated for EVRTAAA. All interventions were performed on the same angiographic system. Patients were consecutively placed in three groups in a seven-month period: “2D angiography” (2DA) (9 patients), “3D rotational angiography” (3DA) (14 patients), and “image fusion” (IF) (14 patients). Injected contrast volume, x-ray exposure (dose-area-product: DAP), and procedure time were recorded. To compare the groups in terms of the above measures and general patient characteristics, statistical tests using Fisher’s Exact, Kruskal-Wallis, and Mann-Whitney were performed. Results Patient characteristics and stenting types were similar between all three groups with no statistically significant differences (p-value>0.05). The IF group showed significant reduction (p-value Conclusion Image fusion road-mapping for EVRTAAA is feasible, and is associated to a statistically significant reduction in contrast volume and a trend towards DAP reduction while maintaining similar procedure time.