Use Of Rotational Angiography Research Articles

Use of rotational angiography with 3D reconstruction as a guide for stent aortoplasty in a pediatric patient with coarctation of the aorta

Use of rotational angiography with 3D reconstruction as a guide for stent aortoplasty in a pediatric patient with coarctation of the aorta

Use of rotational angiography in congenital cardiac catheterisations to generate three-dimensional-printed models.

Three-dimensional printing is increasingly utilised for congenital heart defect procedural planning. CT or MR datasets are typically used for printing, but similar datasets can be obtained from three-dimensional rotational angiography. We sought to assess the feasibility and accuracy of printing three-dimensional models of CHD from rotational angiography datasets. Retrospective review of CHD catheterisations using rotational angiography was performed, and patient and procedural details were collected. Imaging data from rotational angiography were segmented, cleaned, and printed with polylactic acid on a Dremel® 3D Idea Builder (Dremel, Mount Prospect, IL, USA). Printing time and materials' costs were captured. CT scans of printed models were compared objectively to the original virtual models. Two independent, non-interventional paediatric cardiologists provided subjective ratings of the quality and accuracy of the printed models. Rotational angiography data from 15 catheterisations on vascular structures were printed. Median print time was 3.83 hours, and material costs were $2.84. The CT scans of the printed models highly matched with the original digital models (root mean square for Hausdorff distance 0.013 ± 0.003 mesh units). Independent reviewers correctly described 80 and 87% of the models (p = 0.334) and reported high quality and accuracy (5 versus 5, p = NS; κ = 0.615). Imaging data from rotational angiography can be converted into accurate three-dimensional-printed models of CHD. The cost of printing the models was negligible, but the print time was prohibitive for real-time use. As the speed of three-dimensional printing technology increases, novel future applications may allow for printing patient-specific devices based on rotational angiography datasets.

Use of rotational angiography in assessing relationship of the airway to vasculature during cardiac catheterization.

We are the first to describe the use of three-dimensional rotational angiography (3DRA) in creating multiplanar reconstruction (MPR) and volume rendering, in the catheterization suite, of airways at risk for compression by adjacent cardiac structures. 3DRA has emerged as a promising tool for improved visualization of cardiac and vascular structures in congenital heart disease. This is a retrospective review of all available cases at our institution in which MPR from 3DRA was used to assess airways in relation to surrounding cardiovascular structures. Eight cases were reviewed from January 1, 2011 to November 30, 2013. Seven children had complex biventricular anatomy, including repaired truncus arteriosus, repaired absent pulmonary valve, repaired double outlet right ventricle, and vascular rings. One child had double inlet left ventricle and had undergone a hybrid procedure (stenting of the patent ductus arteriosus and banding of bilateral pulmonary arteries) before the Glenn procedure. Six of these cases involved distortion or stenosis of the pulmonary conduit or branch pulmonary arteries. In all cases, the trachea and the main bronchi were clearly visualized using MPR. Management was affected by the visualization of the airways during the catheterization procedure in seven of eight cases. Four cases had intraprocedural bronchoscopy that confirmed airway findings seen by MPR. In one case, computed tomography confirmed left bronchial compression seen by MPR. 3DRA can visualize airway anatomy and its relationship to the vasculature accurately. This has significant implications for preinterventional planning, intraprocedural management, as well as postprocedural recovery.

Application Protocols for the Use of Rotational Angiography (3DRA) in Congenital Heart Disease

Application Protocols for the Use of Rotational Angiography (3DRA) in Congenital Heart Disease

Rotational angiography for diagnosis and surgical planning in the management of spinal vascular lesions

The management of spinal vascular malformations has undergone significant evolution with the advent of advanced endovascular and angiographic technology. Three-dimensional rotational spinal angiography is an advanced tool that allows the surgeon to gain a better appreciation of the anatomy of these spinal vascular lesions and their relation to surrounding structures. This article describes the use of rotational angiography and 3D reconstructions in the diagnosis and management of spinal vascular malformations. The authors present representative cases involving surgical treatment planning for spinal vascular malformations with focus on the utility and technique of rotational spinal angiography. They report the use of rotational spinal angiography for a heterogeneous collection of vascular pathological conditions. Eight patients underwent rotational spinal angiography in addition to digital subtraction angiography (DSA) for the diagnosis and characterization of various spinal vascular lesions. Postprocessed images were used to characterize the lesion in relation to surrounding bone and to enhance the surgeon's ability to precisely localize and obliterate the abnormality. The reconstructions provided superior anatomical detail compared with traditional DSA. No associated complications from the rotational angiography were noted, and there was no statistically significant difference in the amount of radiation exposure to patients undergoing rotational angiography relative to traditional angiography. The use of rotational spinal angiography provides a rapid and powerful diagnostic tool, superior to conventional DSA in the diagnosis and preoperative planning of a variety of spinal vascular pathology. A more detailed understanding of the anatomy of such lesions provided by this technique may improve the safety of the surgical approach.

3‐D guidance of complex pulmonary artery stent placement using reconstructed rotational angiography with live overlay

Technologies which allow rotational angiographic image acquisition and three dimensional (3-D) vascular reconstruction with subsequent fluoroscopic registration for live 3-D image overlay are rapidly being adopted. We present the first use of rotational angiography with integrated 3-D image overlay for guidance during complex pulmonary artery stent placement. Technical considerations, advantages, and limitations of this procedural strategy are discussed.

Nonvariceal Upper Gastrointestinal Bleeding: the Usefulness of Rotational Angiography after Endoscopic Marking with a Metallic Clip

ObjectiveWe wanted to assess the usefulness of rotational angiography after endoscopic marking with a metallic clip in upper gastrointestinal bleeding patients with no extravasation of contrast medium on conventional angiography.Materials and MethodsIn 16 patients (mean age, 59.4 years) with acute bleeding ulcers (13 gastric ulcers, 2 duodenal ulcers, 1 malignant ulcer), a metallic clip was placed via gastroscopy and this had been preceded by routine endoscopic treatment. The metallic clip was placed in the fibrous edge of the ulcer adjacent to the bleeding point. All patients had negative results from their angiographic studies. To localize the bleeding focus, rotational angiography and high pressure angiography as close as possible to the clip were used.ResultsOf the 16 patients, seven (44%) had positive results after high pressure angiography as close as possible to the clip and they underwent transcatheter arterial embolization (TAE) with microcoils. Nine patients without extravasation of contrast medium underwent TAE with microcoils as close as possible to the clip. The bleeding was stopped initially in all patients after treatment of the feeding artery. Two patients experienced a repeat episode of bleeding two days later. Of the two patients, one had subtle oozing from the ulcer margin and that patient underwent endoscopic treatment. One patient with malignant ulcer died due to disseminated intravascular coagulation one month after embolization. Complete clinical success was achieved in 14 of 16 (88%) patients. Delayed bleeding or major/minor complications were not noted.ConclusionRotational angiography after marking with a metallic clip helps to localize accurately the bleeding focus and thus to embolize the vessel correctly.

Nonvariceal Upper Gastrointestinal Bleeding: the Usefulness of Rotational Angiography after Endoscopic Marking with a Metallic Clip

Nonvariceal Upper Gastrointestinal Bleeding: the Usefulness of Rotational Angiography after Endoscopic Marking with a Metallic Clip

Rotational Angiography (DynaCT) and Its Use in Guiding Ablation Procedures in Chambers Other than Left Atrium

Aims: To assess the usefulness of rotational angiography using DynaCT (Seimens) 3D reconstruction of cardiac chambers in guiding ablation in complex cardiac arrhythmia involving chambers other than Left Atrium. DynaCT and have proven to be helpful in left atrial reconstruction, however its usefulness in ablation procedures involving other cardiac chambers in unknown. Methods: Mapping and ablation was done in 13 patients with concomitant DynaCT and 3D Electroanatomic mapping using NavX or Ensite System (SJM). DynaCT was used to create 3D images of the heart chambers and the 3D image superimposed on live fluoro. Results: RA was reconstructed in 4, LV in 5 and RV in 3 patients. Additionally the aortic root and left coronary ostium was reconstructed in 1 patient. In all pts 3D reconstruction was possible and the image was overlayed on real time fluoroscopic image to guide catheter manipulation and ablation. The time required to produce a 3D image was 5–15 (8.3±4.7) minutes. LV aneurysm was delineated in 3 patients allowing definition of aneurysm along its edges. Conclusion: DynaCT can be used to create 3D images of any chamber of the heart. It improves accuracy of structural anatomy and allows catheter manipulation using real-time road-maps. It is an important aid in ablation procedures even in cases where electro-anatomic mapping is used.

Usefulness of Rotational Angiography in the Assessment of Cerebral Aneurysm and Arteriovenous Malformation

Usefulness of Rotational Angiography in the Assessment of Cerebral Aneurysm and Arteriovenous Malformation