Successful endovascular treatment of severe chronic mesenteric ischemia facilitated by intraoperative positioning system image guidance

Muluk, Satish C.; Elrakhawy, Mahmoud; Chess, Bart A.; Rosales, Carlos; Goel, Vikash

doi:10.1016/j.jvscit.2021.11.001

Cited by 14 publications

(3 citation statements)

References 3 publications

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“…Ultrasound, fiber optic real shape (FORS), and EM navigation guidance have been described as alternative options to reduce x-ray imaging during endovascular procedures. 1 A recent publication by Muluk et al 2 reports successful IOPS guidance to perform superior mesenteric artery (SMA) stenting.…”

Section: Discussionmentioning

confidence: 99%

Branched Endovascular Thoracoabdominal Aneurysm Repair Under Electromagnetic Guidance in an in Vitro Model

Goel¹,

Rebet²,

Hengstum

et al. 2023

J Endovasc Ther

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Purpose: We report a new approach to perform endovascular treatment of thoracoabdominal aneurysms under electromagnetic navigation guidance using a modified system (IOPS; Centerline Biomedical, Inc., Cleveland, OH, USA) and a modified branched endograft (E-nside TAAA Multibranch Stent Graft System; Artivion Inc., Kennesaw, GA, USA). Case Report: We performed this case in an aortic in vitro model made from transparent polyurethane in our research hybrid room (Discovery IGS 730; GE HealthCare, Chicago, IL, USA). While the implantation of this device typically involves several challenging steps, including precise endograft implantation, snaring of preloaded guide wires, and cannulation of target visceral arteries, all were successfully performed using electromagnetic navigation guidance. Conclusion: Our preliminary experience suggests that endograft implantation under electromagnetic navigation guidance in an integrated hybrid operating room is an innovative option to address technical challenges and reduce patient and operator radiation exposure associated with complex endovascular surgery. Clinical Impact Most steps of a branched endografting procedure can be performed without X-Ray exposure when using electromagnetic navigation guidance and a modified branched endograft.

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Section: Discussionmentioning

confidence: 99%

Branched Endovascular Thoracoabdominal Aneurysm Repair Under Electromagnetic Guidance in an in Vitro Model

Goel¹,

Rebet²,

Hengstum

et al. 2023

J Endovasc Ther

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“…Intra-operative positioning system (IOPS) is a novel endovascular navigation system that does not use radiation or contrast, instead using electromagnetic sensors to provide 3D roadmaps to guide intervention [48]. Unfortunately, no papers passed through the full text search stage for IOPS.…”

Section: Intra-operative Positioning Systemmentioning

confidence: 99%

A State-of-the-Art Review of Intra-Operative Imaging Modalities Used to Quality Assure Endovascular Aneurysm Repair

Bachrati

Torre

Chowdhury

et al. 2023

JCM

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Endovascular aortic aneurysm repair (EVAR) is the preferred method for elective abdominal aortic aneurysm (AAA) repair. However, the success of this technique depends greatly on the technologies available. Intra-operative imaging is essential but can come with limitations. More complex interventions lead to longer operating times, fluoroscopy times, and greater contrast doses. A number of intra-operative imaging modalities to quality assure the success of EVAR have been developed. A systematic literature search was performed with separate searches conducted for each imaging modality in the study: computed tomography (CT), digital subtraction angiography (DSA), fusion, ultrasound, intra-operative positioning system (IOPS), and non-contrast imaging. CT was effective at detecting complications but commonly resulted in increased radiation and contrast dose. The effectiveness of DSA can be increased, and radiation exposure reduced, through the use of adjunctive technologies. We found that 2D-3D fusion was non-inferior to 3D-3D and led to reduced radiation and contrast dose. Non-contrast imaging occasionally led to higher doses of radiation. Ultrasound was particularly effective in the detection of type II endoleaks with reduced radiation and contrast use but was often operator dependent. Unfortunately, no papers made it past full text screening for IOPS. All of the imaging techniques discussed have advantages and disadvantages, and clinical context is relevant to guide imaging choice. Fusion and ultrasound in particular show promise for the future.

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“…Стремительное развитие абдоминальной и эндоваскулярной хирургии обусловливает необходимость детального изучения особенностей строения сосудов брюшной полости [1][2][3][4][5]. Верхняя брыжеечная артерия (ВБА) начинается от аорты позади тела поджелудочной железы, проходит перед горизонтальной частью двенадцатиперстной кишки и проникает в корень брыжейки тонкой кишки, где даёт множество ветвей: нижнюю панкреатодуоденальную, тощекишечные и подвздошно-кишечные артерии, подвздошно-ободочную, а также правую и среднюю ободочно-кишечные артерии.…”

Section: актуальностьunclassified

Variant anatomy of the colonic and aberrant branches of the superior mesenteric artery

Гайворонский

Быков²,

Gaivoronskaya³

et al. 2022

Kazan Med J

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Background. The rapid development of abdominal, endovascular surgery and transplantology necessitate a detailed study of the structural features of the abdominal cavity vessels. Aim. To study the variant anatomy of the colonic branches of the superior mesenteric artery in men and women. Material and methods. The study was conducted based on the analysis of the results of multislice spiral computed tomography, a total of 2300 computed tomograms of adults aged 25 to 75 years (913 males and 1387 females) were studied. To assess the statistical significance of the aorta branches architectonics variants frequency dependence on gender, the method of analyzing four-field tables (Pearson's chi-square test) was used. The correlation strength was assessed using the normalized value of the Pearson coefficient. Results. It has been established that the branches of the superior mesenteric artery, which vascularize the large intestine, have a wide range of variant anatomy. According to their number and the presence of aberrant branches, these variants can be classified into mono-, bi-, tri-, quadri- and penta-arterial. The most common variant of the architectonics of these branches of the superior mesenteric artery is biarterial. Mono- and pentaarterial branching variants of the colonic branches of the superior mesenteric artery are extremely rare in both sexes. The iliocolic and middle colic arteries are permanent branches of the superior mesenteric artery, and the right colic artery may be absent (in 7% of cases in males and 19% in females). Among the aberrant branches of the superior mesenteric artery, we noted the arteries involved in the blood supply to the liver: the right accessory, right replacement, and common hepatic arteries. In men in 25% of cases, in women in 16% of cases, a deviation from the superior mesenteric artery of the aberrant hepatic branch was noted. Conclusion. The architecture of the colonic branches of the superior mesenteric artery is characterized by a wide range of variant anatomy and a high incidence of aberrant hepatic arteries.

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Successful endovascular treatment of severe chronic mesenteric ischemia facilitated by intraoperative positioning system image guidance

Cited by 14 publications

References 3 publications

Branched Endovascular Thoracoabdominal Aneurysm Repair Under Electromagnetic Guidance in an in Vitro Model

Branched Endovascular Thoracoabdominal Aneurysm Repair Under Electromagnetic Guidance in an in Vitro Model

A State-of-the-Art Review of Intra-Operative Imaging Modalities Used to Quality Assure Endovascular Aneurysm Repair

Variant anatomy of the colonic and aberrant branches of the superior mesenteric artery

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