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Published in: European Radiology 11/2016

01-11-2016 | Interventional

Balloon pulmonary angioplasty: applicability of C-Arm CT for procedure guidance

Authors: Jan B. Hinrichs, Julius Renne, Marius M. Hoeper, Karen M. Olsson, Frank K. Wacker, Bernhard C. Meyer

Published in: European Radiology | Issue 11/2016

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Abstract

Purpose

To investigate the feasibility of and compare two C-Arm CT (CACT) guidance methods during balloon pulmonary angioplasty (BPA).

Material and methods

Forty-two BPAs [27 CTEPH patients (nine males, 70 ± 14y)] targeting 143 pulmonary arteries were included. Twenty-two BPAs were guided by contrast-enhanced CACT acquired immediately before BPA (G3D). In another 20 BPAs (G2D), two orthogonal fluoroscopy images of the chest where acquired to compute a registration of a previously acquired CACT. Volume rendering-based graphic representations (VRT guidance) were generated indicating the origin and course of the vessels. Based on VRT guidance, the intervention was planned. Procedure durations and radiation exposure data were compared between the two groups (Wilcoxon test).

Results

The overall intervention time was approximately 2 h in both groups (p = 0.31). BPA was successfully performed in G3D 91 % and G2D 94 %. No significant difference was found concerning the mean dose area product (DAP) related to fluoroscopy (p = 0.38), while DAP related to DSA was slightly higher in G3D (p = 0.048). Overall, DAP was significantly higher in G3D (p = 0.002).

Conclusions

The use of CACT for procedure guidance in patients undergoing BPA is feasible and accurate. Image fusion of a pre-acquired CACT can be used to decrease radiation exposure due to multiple BPA sessions.

Key Points

BPA guidance by CACT overlay is feasible and safe.
2D3D image fusion for BPA guidance is accurate.
Image fusion can reduce patient radiation dose due to repeated BPA sessions.
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Metadata
Title
Balloon pulmonary angioplasty: applicability of C-Arm CT for procedure guidance
Authors
Jan B. Hinrichs
Julius Renne
Marius M. Hoeper
Karen M. Olsson
Frank K. Wacker
Bernhard C. Meyer
Publication date
01-11-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 11/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4280-z

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