Safety and Accuracy of Endovascular Aneurysm Repair Without Pre-operative and Intra-operative Contrast Agent

Abstract

EVAR without the use of pre-operative and intra-operative contrast agents appears to be safe and accurate for patients with severe chronic kidney disease.

Feasibility and accuracy of fusion imaging during thoracic endovascular aortic repair

“…Kobeiter et al have published a case of zero contrast TEVAR using fusion imaging in the descending aorta with ultrasound verification of fusion imaging position 5 and Kaladji et al described a case of noncontrast TEVAR by catheterizing the subclavian artery to adjust fusion imaging. 9 However, in our opinion, a minimal DSA to confirm the position of fusion imaging and adjust for deviation is the most common and moreover precise and secure manner. It is recommended, at least when critical aortic branch vessels are close to the landing zone.…”

Fusion Imaging for EVAR with Mobile C-arm

“…If the current system only uses information extracted from the preoperative 3D CT scan, other types of imaging modalities (MRI, non-enhanced CT, ultrasound) could also be considered and is a subject of further improvement. The first publications for fusion imaging described systems that could only perform 3D/3D registration, which required CBCT at the start of the procedure (19,21,22). Given the radiation emitted by CBCT, systems evolved towards 3D/2D registration(3) that restricted CBCT to post-procedure assessment (23)(24)(25)(26).…”

Endoanchors under 3D image fusion for a type IA endoleak after EVAR

“…Therefore, we favor the FI approach in reinterventions because of its potential to significantly decrease radiation exposure while facilitating greater anatomical and procedural visualization. Zero‐contrast reintervention procedures, such as zero‐contrast EVARs, have been reported in literature with FI 3D road mapping . This is an important development because patients who undergo endovascular procedures are very frequently exposed to follow‐up X‐ray examinations and secondary procedures, ultimately increasing their radiation and contrast exposure.…”

“…Zero-contrast reintervention procedures, such as zero-contrast EVARs, have been reported in literature with FI 3D road mapping. 23,24 This is an important development because patients who undergo endovascular procedures are very frequently exposed to follow-up X-ray examinations and secondary procedures, ultimately increasing their radiation and contrast exposure.…”