Rotational Digital Angiography Research Articles

Efficacy of 360-degree three-dimensional rotational pulmonary angiography to guide percutaneous transluminal pulmonary angioplasty.

Percutaneous transluminal pulmonary angioplasty (PTPA) is performed with balloon dilatation of the target lesions in the pulmonary arteries through a catheter (Online Figure 1A-Online Figure 1C, Moving image 1, Moving image 2). We routinely perform pulmonary angiography (PAG) using a rotational digital angiography system (Artis zeego multi-axis; Siemens AG, Forchheim, Germany) before the PTPA procedure (Moving image 3). A 360-degree three-dimensional (3D) PAG image is used for identifying the target lesions and estimating their perfusion area easily and rapidly, in addition to identifying the anatomical structures of the pulmonary arteries (Figure 1A, Moving image 4). A rotational 3D PAG image can help us develop therapeutic strategies during PTPA procedures, including guide catheter and balloon size selection. Furthermore, we can visualise the pulmonary artery anatomy in synchronisation with the realtime angiographic view during the procedure, resulting in safe and easy wiring. The rotational 3D PAG image after PTPA is shown in Figure 1B and Moving image 5. Accordingly, this rotational 3D PAG image contributes to the safe and easy performance of PTPA and reduces the amount of contrast agent, leading to a reduction in radiation exposure.

Rotational Digital Angiography for the Evaluation of Iliac Artery Disease.

Ten cases with iliac artery disease were evaluated using rotational angiography with revolution of the arm of the X-ray tube support unit. The tip of the catheter was advanced to the infrarenal aorta, and contrast medium was injected at a rate of 6-10 ml/second. Digital angiographic images from multiple projection angles were acquired at 15 frames/second with a rotation speed at about 10 degrees/second and a range of greater than 90 degrees. This method made it possible to detect ulcerations of the artery, which could not be visualized using conventional single-plane angiography. The three-dimensional structure of a dissection could also be visualized. In seven cases of occlusive iliac artery disease, comparison with rotational angiography revealed that anteroposterior views of single-plane angiography underestimated the extent of the disease in four cases and overestimated the extent of the disease in one case. In two cases, no additional clinical information was obtained. In conclusion, rotational angiography provides accurate three-dimensional information concerning the lumen of the iliac arteries.

New imaging modalities in the catheterization laboratory

To provide an overview of the various modalities that have emerged in the last years as adjunctive tools to provide detailed imaging of the cardiovascular system in the catheterization laboratory. Completion angiography after cardiac surgery for congenital heart disease using a dedicated hybrid operating cardiac suite may aid in early diagnosis and therapy of postsurgical abnormalities. The application of three-dimensional rotational digital angiography results in a more precise delineation of the three-dimensional anatomy of vascular structures outside the heart with rapid image processing and reduction of the amount of contrast used and ionizing radiation dose. Combined catheterization/magnetic resonance (MR) hybrid laboratories have the potential to accurately assess changes in the anatomy and physiology pretranscatheter and posttranscatheter interventions. Fully MR-guided transcatheter procedures have become possible in animal models. Real-time three-dimensional transesophageal echocardiography (TEE) has helped to guide transcatheter procedures in septal and valvar structures. Miniaturization of probes has expanded the applications of TEE for smaller neonates. The use of intravascular ultrasound has helped to better understand the mechanisms of vascular diseases and transcatheter treatments. Knowledge and proper application of new imaging modalities during interventions in the catheterization laboratory may improve the outcomes of patients with congenital and acquired structural heart disease.

Automatic registration using implicit shape representations: applications in intraoperative 3D rotational angiography to preoperative CTA registration

A solution for automatic registration of 3D Rotational Angiography (XA) to CT/MR of the liver. Targeted for use in treatment planning of liver interventions. A shape-based approach to registration is proposed that does not require specification of landmarks nor is it prone to local minima like purely intensity-based registration methods. Through the use of vessel characteristics, accurate registration is possible even in the presence of deformations induced by catheters and respiratory motion. Registration was performed on eight pairs of multiphase CT angiography and 3D rotational digital angiography datasets. Quantitative validation of the registration accuracy using vessel landmarks was performed on these datasets. The validation study showed that the method has a registration error of 9.41 +/- 4.13 mm. In addition, the computation time is well below 60 s making it attractive for clinical application. A new method for fully automatic 3DXA to CT/MR image registration was developed and found to be efficient and accurate using clinically realistic datasets.

Three-dimensional rotational digital angiography in catheter-based congenital heart disease interventions

Rigatelli, Gianluca; Zamboni, Alberto; Cardaioli, Paolo; Scaranello, Fiorenzo; Giordan, Massimo; Dell'Avvocata, Fabio; Zattoni, Luca; Bedendo, Emiliano Author Information

Clinical applications of Three-dimensional image reconstruction using rotational digital angiography technique in congenital cardiopathy

目的 评价平板旋转血管造影及三维重建在先天性心脏病临床应用的价值.方法 回顾了34例先天性心脏病患者的CT或MR、二维血管造影、旋转血管造影及三维重建影像学资料,并对其结果进行对比分析.结果 行胸主动脉造影33例.其中肺动脉瓣闭锁主动脉侧支14例,法乐氏四联症主动脉侧支9例,动脉导管未闭8例,主动脉缩窄1例,主动脉弓畸形1例.行无注射对比剂房间隔堵闭器扫描重建1例.2例肺动脉瓣闭锁主动脉侧支,6例动脉导管未闭进行了介入治疗,侧支及动脉导管堵闭效果良好.旋转血管造影及三维重建和常规二维血管造影、CT及MR对比结果基本相符.旋转血管造影及三维重建相对常规二维血管造影更加快捷、方便,提供更多影像学信息.和CT或MR相比更能够清楚、直观、精确的显示检查区域的解剖结构,并且能够为介入治疗直接提供更多影像学资料.结论 旋转血管造影及三维重建对先天性心脏病主动脉病变有较高的 临床应用价值,提高诊断的准确性和介入治疗的安全性及疗效。

Three-dimensional rotational digital angiography for difficult internal iliac artery embolization in endovascular aneurysm repair candidates

Three-dimensional rotational digital angiography for difficult internal iliac artery embolization in endovascular aneurysm repair candidates

Three‐dimensional rotational digital angiography in a complicated case of patent ductus arteriosus transcatheter closure

There has been no report so far as to the usefulness of 3D rotational angiography in congenital heart disease interventions. We present a case of a difficult patent ductus arteriosus in which 3D rotational angiography was the key to successful closure. A 64-year-old woman who had been operated on many years previously for a patent ductus arteriosus came to our attention for a heart murmur on the left upper sternal border. Echocardiography revealed a still patent duct with moderate shunt. The patient underwent cardiac magnetic resonance imaging, which confirmed patency of the duct, but its diameter and length were difficult to measure due to the particular orientation and morphology of the previously legated duct. It was decided to attempt device closure. Three-dimensional rotational digital subtraction technique enabled us to find the most useful projection for measuring the duct and selecting the best implant device (coil or Amplatzer device). The exact oblique and cranio-caudal degree of the selected projection on rotational 3D reconstruction was replicated to obtain the best standard digital subtraction angiographic view of the duct. Thus, a 5/4-mm Amplatzer Duct Occluder was selected and successfully implanted with excellent results. This case suggests that 3D rotational angiography may be an important imaging tool to guide congenital heart disease interventions such as patent ductus arteriosus closure or aortic coarctation repair.

SU-FF-I-14: Region-Of-Interest (ROI) Cone-Beam Computed Tomography (CBCT) Using Rotational Digital Angiography (DA) Acquisitions

Purpose: Region-of-interest (ROI) cone beam computed tomography (CBCT) promises significant integral dose reduction to patients during acquisition; however, reconstruction using these data result in truncation artifacts both inside and outside the ROI. We propose a new technique to equalize the intensity in the region outside the ROI to that inside to achieve reconstructions comparable to full-field-of-view (FFOV) CBCT. Method and Materials: A ROI filter comprised of a 2.25 cm diameter central aperture in 0.21 g/cm2 gadolinium screens was installed on the x-ray-tube assembly of a standard C-arm gantry. Standard (unsubtracted) Rotational Digital Angiography (DA) acquisitions were performed of a head phantom. FFOV images without the filter in place were also obtained. The location of the ROI in the projection images was identified using edge detection and template matching. Intensities outside the ROI were equalized to those inside the ROI by mapping the intensities at the same percentiles in the cumulative histograms of these regions for every image. The equalized images were reconstructed using the 3D reconstruction software of the acquisition apparatus. Results: Inside the ROI, the reconstruction data are highly correlated to the FFOV data (R2 = 0.87). Outside the ROI, the reconstruction while noisier due to fewer photons is comparable to the FFOV, but some artifacts due to the incomplete equalization and detection of the ROI edges, are visible. Further refinement methods are being investigated. Integral Dose Reduction was estimated to be 80% compared to the FFOV 12″ acquisition. Conclusion: DA-ROI-CBCT promises to be a feasible clinical technique for non-subtracted applications such as those in cardiology and orthopedics allowing substantial integral dose reduction to the patient, while providing similar reconstructions to standard FFOV acquisitions. Support: NIH Grants R01-NS43924, R01-EB002873, Sterbutzel Funds, Toshiba Medical Systems Corporation.

Cavernous Sinus Dural Fistula Treated by Transvenous Facial Vein Approach

We report on the endovascular treatment of the spontaneous indirect dural carotid cavernous sinus type D fistula in a 60-year-old woman, in whom ipsilateral facial, angular and superior ophthalmic veins catheterization was performed to get access to the fistula site for embolization treatment. Approach via the facial vein is helpful after inferior petrosal sinus treatment failure. Although this technique requires caution in the angular vein region it allows a safe and effective treatment of these lesions. 3D rotational digital angiography can obtain more information of the angioarchitecture of the cavernous plexus and venous outflow for the catheter navigation.

Development of rotational digital angiography system — clinical value in acute pulmonary thromboembolism

A rotational digital angiography system was newly developed by authors. During the rotation, a pulse exposure is done at every 1.25° by computer control, so that 288 different projectional images can be acquired following a single injection of contrast medium. Because rotational image data can be easily reconstructed to 3-D images, more useful diagnostic informations are obtained. Rotational digital angiography was performed for 15 patients with acute pulmonary thromboembolism, and massive thromboemboli were revealed in all patients. The diagnostic usefulness of this new system has also proven to be improved in the interventional procedures. At the appropriate angle, the thrombosed vessels were clearly distinguished. Thus, as the tip of the catheter was advanced to the target site, the thrombosed lesion could be exclusively treated by interventional techniques. The device has, therefore, been found to be of great value in the diagnosis and intervention of acute pulmonary thromboembolism.

Rotational digital angiography for the evaluation of iliac artery disease

Rotational digital angiography for the evaluation of iliac artery disease

Rotational Digital Angiography for the Evaluation of Iliac Artery Disease

Ten cases with iliac artery disease were evaluated using rotational angiography with revolution of the arm of the X-ray tube support unit. The tip of the catheter was advanced to the infrarenal aorta, and contrast medium was injected at a rate of 6–10 ml/second. Digital angiographic images from multiple projection angles were acquired at 15 frames/second with a rotation speed at about 10°/second and a range of greater than 90°. This method made it possible to detect ulcerations of the artery, which could not be visualized using conventional single-plane angiography. The three-dimensional structure of a dissection could also be visualized. In seven cases of occlusive iliac artery disease, comparison with rotational angiography revealed that anteroposterior views of single-plane angiography underestimated the extent of the disease in four cases and overestimated the extent of the disease in one case. In two cases, no additional clinical information was obtained. In conclusion, rotational angiography provides accurate three-dimensional information concerning the lumen of the iliac arteries.

Bleeding jejunal leiomyoma: Successfully treated with emergent embolotherapy using rotational digital angiography system

Bleeding jejunal leiomyoma: Successfully treated with emergent embolotherapy using rotational digital angiography system

Development of rotational digital angiography and new cone-beam 3D image: Clinical value in vascular lesions

Despite the rapid improvement of new imaging modalities such as CT, MRI and echography techniques, angiography still plays the role of gold standard for the diagnosis of vascular lesions. The main reason for this dependence on angiography is its superiority in the S/N ratio and spatial resolution. However, the essential problem remained in angiography, even in modern DSA, is that, after a single injection of contrast medium, imaging is done from only one or two projections. Serial filming by rotating method of the X-ray unit around the longitudinal axis of the target organ will theoretically solve the above problem. This method has been documented at times for cerebral angiography since the report of Cornelis et al. [1], while the rotational digital X-ray system sufficient to various human organs has been described by few authors [2, 3]. The aim of this paper is to discuss the value of the new system from the clinical view.

241 血管撮影用ポジショニング支援ソフト(COMPAS)を用いたdigital rotational angiographyの試み : 第3報

241 血管撮影用ポジショニング支援ソフト(COMPAS)を用いたdigital rotational angiographyの試み : 第3報

82 血管撮影用ポジショニング支援ソフト(COMPAS)を用いたdigital回転血管撮影の試み-第2報-(第25回秋季学術大会一般研究発表予稿集)

82 血管撮影用ポジショニング支援ソフト(COMPAS)を用いたdigital回転血管撮影の試み-第2報-(第25回秋季学術大会一般研究発表予稿集)

Development of rotational digital angiography system and new cone-beam 3 D CT

Development of rotational digital angiography system and new cone-beam 3 D CT