Purpose. To quantify the displacement of the vascular structures after insertion of stiff devices during endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm, and to identify potential parameters influencing this displacement. Materials and Methods. A total of 50 patients from a single center undergoing EVAR were prospectively enrolled between January 2016 and December 2017. Fusion imaging was employed using the EndoNaut® (Therenva, France) station through a 3D/2D technology synchronizing the 3D CT-scan to the live intraoperative fluoroscopy. The accuracy of the fusion road-map was evaluated before deployment by conventional digital subtraction angiogram on a single plane (with different Carm incidences). Results. The mean displacement error of the ostium of the lowest renal artery was 4.1 +/-2.4 mm (range 0-11.7 mm), with a left/right displacement of 1.6 +/-1.7 mm (range 0-6.9 mm) and a craniocaudal displacement of 3.5 +/-2.4 mm (range 0-11.3 mm). The correction required for the ostium of the lower renal artery was mostly cranial and to the left. Multiple linear regression analysis revealed only the sharpest angle between the aneurysm neck and sac as the factor influencing the accuracy of fusion imaging. All other parameters didn't show any correlation. 1 A c c e p t e d M a n u s c r i p t Conclusion. This study identified the sources of fusion error after insertion of rigid material during EVAR. As the sharpest angulation between aneurysm neck and sac increases, the overall accuracy of the fusion might be affected.

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En 2050, la France devra être neutre en carbone. Même si la consommation énergétique diminuera grâce aux gains permis par l’efficacité énergétique, les transferts d’usage vers l’électricité bas carbone nécessiteront une hausse de la production d’électricité. Toutes les technologies devront alors être mobilisées. Tour d’horizon de la maturité, des coûts et des perspectives de développement des technologies bas carbone.