The fluoro-less and contrast-less peripheral endovascular intervention: Halfway there

Ephrem, Georges; Garikipati, Sireesha; Hanson, Ivan

doi:10.1016/j.carrev.2016.05.005

Cited by 2 publications

(3 citation statements)

References 13 publications

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“…In the cardiology eld frame rates of 4 fps have been proven e ective when used in combination with frame-interpolation to keep su cient image uency and reduce icker. 28,29 Collimation Collimation should be used to reduce the eld of view whenever possible without interfering with the task at hand. Collimation decreases the area of irradiation and thereby proportionally decreases the DAP and image noise.…”

Section: Anticipate High Radiation Exposurementioning

confidence: 99%

“…Additionally, three case reports and two prospective studies demonstrated the feasibility of IVUS imaging to reduce or avoid injection of contrast material in patients with severe chronic kidney disease or contrast allergy. [24][25][26][27]61 In the majority of the studies, IVUS was complemented with CO 2 angiography to visualize overall condition of the vascular tree. [62][63][64] Revascularization success was 100% in all ve studies.…”

Section: Ivus Cathetersmentioning

confidence: 99%

“…[54][55][56][57]65,66 In selected patients with severe chronic kidney disease or contrast allergy, IVUS can form a viable alternative to angiography for diagnosis and treatment veri cation. [62][63][64]67,68 Integration of IVUS in re-entry devices can aid subintimal revascularization of guidewire-resistant CTOs and lead to improved technical success and reduced complications by supporting true lumen re-entry. 69,70 Intravascular optical coherence tomography Intravascular optical coherence tomography (OCT) is in many ways comparable to IVUS: both are catheter-based imaging methods that provide cross-sectional imaging of the lumen and arterial wall.…”

Section: Ivus-integrated Devicesmentioning

confidence: 99%

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Intraoperative imaging, navigation and radiation management in aortic and peripheral endovascular procedures

Jansen

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Endovascular techniques are essential in treating vascular conditions, to ensure safe and rapid recovery, particularly for elderly and vulnerable patients. Approximately 60% of vascular treatments currently employ endovascular techniques. Within the expanding field of endovascular techniques, there is a growing demand for advanced imaging technology. The current reliance on fluoroscopy has limitations, including exposure to radiation and limited 3D interpretation. This dissertation primarily focuses on reducing radiation exposure and optimizing intraoperative imaging and navigation, with an emphasis on introducing Fiber Optic RealShape (FORS) technology developed by Philips Medical. FORS enables real-time 3D visualization of guidewires and catheters while minimizing radiation use. This innovation promises significant progress in the quality of endovascular treatments. The dissertation also explores other methods to decrease radiation exposure, such as using radiation-absorbing cloths, and provides guidelines for optimizing the operating room setup. Additionally, it offers a comprehensive overview of current imaging and navigation in peripheral endovascular procedures, delving into image fusion—a technique combining conventional real-time fluoroscopy with 3D imaging data. The study focuses on artery displacement during operations and the challenges it poses to guidance accuracy. The dissertation underscores the critical importance of advanced imaging technologies for advancing endovascular techniques and provides practical solutions to overcome current limitations, significantly enhancing the quality of endovascular treatments.

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Section: Anticipate High Radiation Exposurementioning

confidence: 99%

Section: Ivus Cathetersmentioning

confidence: 99%

Section: Ivus-integrated Devicesmentioning

confidence: 99%

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Intraoperative imaging, navigation and radiation management in aortic and peripheral endovascular procedures

Jansen

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Standardisation of Technique and Volume of Iodinated Contrast Administration During Infrainguinal Angioplasty

Bates

Ghanem

Hague

et al. 2020

CPD

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Background: Acute Kidney injury is recognised to occur after administration of iodinated contrast during endovascular interventions for peripheral arterial disease. There are no standardised protocols for contrast delivery during infrainguinal angiography. Objective: The objective of this paper is to review published practice regarding the technique of conventional infrainguinal angiography and intervention, and describe a standard set of subtraction views, injection rates and contrast volumes for infrainguinal angioplasty. Methods: Database searches and review of papers containing (Angioplasty or Angiography) and (“lower limb” or peripheral or infrainguinal) and (method or technique or guidelines or protocol) was performed and defined procedures assessed. Results: A small number of papers provided specific technical details relating to contrast volumes and angiography views. There was considerable variation from authors who have described the contrast volumes used for lower limb angiography. We describe our simple and consistent method. The precise pathophysiology of contrast related nephropathy is under scrutiny. There is interest in new technology to minimise contrast induced kidney injury. Conclusion: Few publications specify iodinated contrast doses, injection volumes or imaging views for infrainguinal arteriography. Standard infrainguinal angioplasty can be performed with conventional equipment using relatively small volumes of contrast by following a systematic technique.

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The fluoro-less and contrast-less peripheral endovascular intervention: Halfway there

Cited by 2 publications

References 13 publications

Intraoperative imaging, navigation and radiation management in aortic and peripheral endovascular procedures

Intraoperative imaging, navigation and radiation management in aortic and peripheral endovascular procedures

Standardisation of Technique and Volume of Iodinated Contrast Administration During Infrainguinal Angioplasty

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