Combined visualization in endovascular treatment lower limb arteries pathology

Резюме

Objective. The purpose of the study was to investigate the effect of intraoperative 3D fusion imaging on the time of surgery, radiation dose and volume of contrast medium during endovascular treatment of peripheral artery disease.

Patients and methods. This prospective, single-center, randomized comparative 30-month trial included a total of 395 patients with lesions of aortofemoral, femoropopliteal segments and tibial arteries. They were all candidates for endovascular revascularization and divided into two groups. The Study Group patients (n=197) underwent operations with combined 3D fusion navigation, whereas the Control Group patients (n=198) were operated on without 3D-imaging. We compared the operation time, radiation dose, and contrast medium volume, followed by analyzing the learning curve.

Results. The operation time in the Study Group amounted to 62.53 (10÷195) min versus 87.82 (6÷340) min in the Control Group (p<0.05), with a time reduction of 29%. The volume of contrast medium in the Study Group amounted to 91.19 (10÷850) vs 168.05 (20÷440) ml in the Control Group (p<0.05), with a decrease of the contrast medium used amounting to 46.6%. The radiation dose in the Study Group was 245.25 (9÷2756) vs 472.92 (5÷3987) mGy in the Control Group (p<0.05), thus showing a reduction by 63.38%. Stratification of the group of combined navigation into 4 subgroups according to the dates of the procedure demonstrated no influence of the potential learning curve on the parameters examined.

Conclusion. The obtained findings demonstrated a significant reduction in the contrast volume (p<0.05), time of surgery (p<0.05) and radiation dose (p<0.05) during endovascular treatment of obliterating sclerosis of lower limb vessels using the technology of combined navigation. These results highlight the potential benefits of routine use of 3D-fusion hybrid imaging when performing endovascular revascularization in patients with PAD.

Ключевые слова:hybrid (combined) visualization; 3D image fusion; peripheral artery disease; contrast volume; operation time; radiation safety; endovascular revascularization

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Study conception and design - Agarkov M.V., Kozlov K.L., Gertsog O.B., Schneider Yu.A.; statistical processing - Agarkov M.V.; draft manuscript preparation - Agarkov M.V.; manuscript revision - Kozlov K.L., Popov V.V., Lyubivyi E.D., Lebedenko E.O., Schneider Yu.A.

For citation: Agarkov M.V., Kozlov K.L., Gertsog O.B., Lyubivyi E.D., Popov V.V., Schneider Yu.A., Lebedenko E.O. Combined visualization in endovascular treatment of pathology of lower limb arteries. Angiology and Vascular Surgery. 2023; 29 (1): 99-108. DOI: https://doi.org/10.33029/1027-6661-2023-29-1-99-108 (in Russian)

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ГЛАВНЫЙ РЕДАКТОР
Акчурин Ренат Сулейманович
Доктор медицинских наук, профессор, академик РАН, заместитель генераль­ного директора по хирургии, руководитель отдела сердечно-сосудистой хирургии ФГБУ «НМИЦ кардиологии им. акад. Е.И. Чазова» Минздрава России, президент Российского общества ангиологов и сосудистых хирургов

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В соответствии с решением президиума Российского общества ангиологов и сосудистых хирургов журналу «Ангиология и сосудистая хирургия» присвоено имя академика А.В. Покровского. Номер регистрации нового наименования:
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